Clostridium Difficile-associated Refractory Pouchitis: Report of Three Cases

  • Ogawa Hitoshi
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Fukushima Kouhei
    Division of GI tract, Tohoku University Graduate School of Medicine Division of Surgical and Molecular Pathophysiology, Tohoku University Graduate School of Medicine
  • Shibata Chikashi
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Miura Koh
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Haneda Sho
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Hayashi Keiichi
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Suzuki Hideyuki
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Sasaki Iwao
    Department of Surgery, Tohoku University Graduate School of Medicine
  • Takahashi Ken-ichi
    Division of Colorectal Surgery, Tohoku Rousai Hospital
  • Funayama Yuji
    Division of Colorectal Surgery, Tohoku Rousai Hospital

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Other Title
  • C.Difficile関連難治性回腸嚢炎の3例

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Description

Pouchitis-the most common complication of total proctocolectomy and anal ileal-pouch anastomosis for ulcerative colitis-is effectively treated in most patients by antibiotic ciprofloxacin or metronidazole therapy, In some cases, however, pouchitis is refractory to these antibiotics. We detected Clostridium difficile toxin A in the feces of three patients suffering from antibiotic-refractory pouchitis whose mucosal inflammation was ameliorated by oral vancomycin treatment. C. difficile should therefore be considered in antibiotic-refractory pouchitis, which requires appropriate medication.

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