Pseudomembranous colitis without diarrhea presenting clinically as acute intestinal pseudo-obstruction.
Pseudomembranous colitis usually presents with diarrhea in a clinical setting of recent antibiotic use. It is uncommon to see it as a cause of obstipation and colonic pseudo-obstruction. We report an unusual case of an elderly woman with hypertension, congestive heart failure, chronic obstructive pulmonary disease, chronic renal insufficiency, and diabetes mellitus, who was admitted with fever, abdominal pain, and distension without diarrhea. She presented with decreased stool frequency and obstipation. She did not respond to conservative management. Colonoscopy revealed a picture of pseudomembranous colitis, and Clostridium difficile toxin was positive. She responded well to metronidazole therapy.
Sheikh
R A
RA
Division of Gastroenterology/Hepatology, San Joaquin General Hospital, Stockton, CA95201, USA.
Yasmeen
S
S
Pauly
M P
MP
Trudeau
W L
WL
D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001706:Biopsy; D003112:Colonic Pseudo-Obstruction / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D003113:Colonoscopy / Q000379:methods; D003287:Contrast Media; D048909:Diabetes Complications; D003974:Diatrizoate Meglumine; D004733:Enema; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications; D008795:Metronidazole / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D014057:Tomography, X-Ray Computed / Q000379:methods
D000890:Anti-Infective Agents; D003287:Contrast Media; D008795:Metronidazole; D003974:Diatrizoate Meglumine