Clin Endosc.  2023 Sep;56(5):666-670. 10.5946/ce.2021.199.

Ischemic colitis complicated by Clostridioides difficile infection treated with fecal microbiota transplantation

• Kang SH
• Gweon TG
• Hwang H
• Baeg MK

• KMID: 2546145
• DOI: http://doi.org/10.5946/ce.2021.199

Abstract

Ischemic colitis is an inflammatory condition of the colon that results from insufficient blood supply commonly caused by enterocolitis, vessel occlusion, or shock. In contrast, pseudomembranous colitis is a clinical manifestation of Clostridioides difficile infection (CDI). Ischemic colitis caused by CDI has rarely been reported. Fecal microbiota transplantation (FMT) is an efficient treatment for refractory or fulminant CDI, and the indications for its use have recently expanded. However, performing FMT in patients with ischemic colitis is challenging because of the risk of perforation. Here, we have presented a case of ischemic colitis caused by CDI that was successfully treated with FMT via sigmoidoscopy.

Keyword

infection; Fecal microbiota transplantation; Ischemic colitis; Pseudomembranous colitis

Figure

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  Fig. 1. Sigmoidoscopic finding. Sigmoidoscopy showing multiple yellowish plaques in the sigmoid colon.

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  Fig. 2. Endoscopic image showing ischemic colitis. (A) Sigmoidoscopy showing multiple various-sized bullae with hemorrhage from the rectum to the distal transverse colon. (B) Focal yellowish pseudomembranes can been seen among the bullae.

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  Fig. 3. Resolution of ischemic colitis. Sigmoidoscopy showing regression of hemorrhagic bullae to crusted blood. Majority of the colon mucosa has recovered.

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