Pseudomembranous colitis complicated by toxic dilatation of the colon
DOI:
https://doi.org/10.11603/2414-4533.2021.1.12028Keywords:
pseudomembranous colitis, dilatation, toxic megacolon, Clostridium difficile, surgical treatmentAbstract
The aim of the work: demonstration of a clinical case of acute toxic dilation of the colon as a complication of the fulminant form of pseudomembranous colitis.
Pseudomembranous colitis associated with Clostridium difficile is a severe consequence of the use of antibiotics. Toxic megacolon is a rare and extremely severe, irreversible, disabling complication of pseudomembranous colitis, which occurs in 0.4–3 % of cases and leads to fatal outcomes in 35–80 % of cases. This complication require surgical treatment, delay which leads to severe systemic intoxication, exhaustion of the patient and fatal outcomes. Obstructive total/subtotal colectomy is the only recommended surgical intervention that can provide a positive prognosis for the patient’s life. Other surgical interventions are associated with a high risk of reoperations and fatal outcomes.
References
Mann, A.P., McCague, A., & Latezarzadeh, F. (2011). Surgical outcome of community-acquired clostridium difficile colitis presenting as toxic megacolon: case report. Surg. Infect., 12 (4), 317-320. DOI: 10.1089/sur.2009.070.
Bhangu, A., Nepogodiev, D., Gupta, A., Torrance, A., & Singh, P., (2012). Systematic review and meta-analysis of outcomes following emergency surgery for Clostridium difficile colitis. Brit. J. Surg., 99 (11), 1501-1513. DOI: 10.1002/bjs.8868.
Sartelli, M., Di Bella, S., McFarland, L.V., Khanna, S., Furuya-Kanamori, L., Abuzeid, N., ..., & Catena, F. (2019). 2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients. World J. Emerg. Surg., 14, 8. DOI: 10.1186/s13017-019-0228-3.
Tallón-Aguilar, L., Herranz-Guerrero, P., López-Ruiz, J.A., Sánchez-Moreno, L., López-Pérez, J., & Padillo-Ruiz, F.J. (2017). Role of care surgery in the treatment of pseudomembranous colitis. Cir. Cir., 85 (4), 330-333. DOI: 10.1016/j.circir.2016.03.012.
Farooq, P.D., Urrunaga, N.H., Tang, D.M., & von Rosenvinge, E.C. (2015). Pseudomembranous colitis. Dis. Mon., 61 (5), 181-206. DOI: 10.1016/j.disamonth.2015.01.006.
Sayedy, L., Kothari, D., & Richards, R.J. (2010). Toxic megacolon associated Clostridium difficile colitis. World J. Gastrointest. Endosc., 2 (8), 293-297. DOI: 10.4253/wjge.v2.i8.293.
Stewart, D.B., Hollenbeak, C.S., & Wilson, M.Z. (2013). Is colectomy for fulminant Clostridium difficile colitis life saving? A systematic review. Сolorectal Dis., 15 (7), 798-804. DOI: 10.1111/codi.12134.
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