Korean J Gastrointest Endosc.  2008 Feb;36(2):112-116.

A Case of Toxic Megacolon Associated with Fulminant Pseudomembranous Colitis

Affiliations
  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. alwayshang@hanyang.ac.kr
  • 2Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.

Abstract

The clinical presentation of Clostridium difficile infection ranges from asymptomatic carriage, colitis with or without pseudomembranes, to fulminant colitis. Although not common, fulminant Clostridium difficile colitis can result in bowel perforation and peritonitis with a high mortality rate. We report a case of toxic megacolon associated with fulminant pseudomembranous colitis. We experienced a case of a 65-year-old male patient who presented with abdominal distension and pain for three days during treatment of pneumonia. We were able to diagnose the case as a toxic megacolon associated with fulminant pseudomembranous colitis. In spite of oral metronidazole treatment and conservative treatment, the clinical course worsened and the patient went into septic shock. The patient underwent a total colectomy but the clinical situation did not improve and the patient died.

Keyword

Toxic megacolon; Clostridium difficile; Pseudomembraneous colitis

MeSH Terms

Aged
Clostridium difficile
Colectomy
Colitis
Enterocolitis, Pseudomembranous
Humans
Male
Megacolon, Toxic
Metronidazole
Peritonitis
Pneumonia
Shock, Septic
Metronidazole
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