title: Colostomy with vancomycin administration as an effective treatment for toxic megacolon associated with fulminant pseudomembranous colitis: a case report.
abstract: We report a case of toxic megacolon associated with fulminant pseudomembranous colitis. A 72-year-old woman was admitted with severe dehydration and shock. Computed tomography showed evidence of diffuse thickening of the colonic wall, colonic dilatation and ascites. She underwent transverse colostomy and received postoperative vancomycin, both orally and by administration from the stoma. Her clinical situation improved dramatically following surgery. When a patient is unable to tolerate subtotal colectomy and ileostomy because of a severe overall condition, temporary colostomy followed by administration of vancomycin through the stoma is recommended.
authors.affiliation: Department of Surgery, Graduate School of Biochemical Sciences, Nagasaki University, Nagasaki, Japan. haraguci@mb.ejnet.ne.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Haraguchi
authors.forename: Ko
authors.initials: K
authors.lastname: Komuta
authors.forename: Junichiro
authors.initials: J
authors.lastname: Furui
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003125:Colostomy; D004761:Enterocolitis, Pseudomembranous / Q000150:complications*; D005260:Female; D006801:Humans; D008532:Megacolon, Toxic / Q000209:etiology / Q000628:therapy*; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin