Pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric Burkitt lymphoma.
Pseudomembranous colitis (PMC) usually manifests as fever and diarrhea in hospitalized patients treated with systemic antibiotics. We described a case of PMC with intestinal obstruction but without diarrhea. A 60-year-old man was hospitalized for chemotherapy for the treatment of Burkitt lymphoma of the stomach. The patient became febrile and complained of crampy abdominal pain during the post-chemotherapy nadir. Plain abdominal radiography showed some intestinal gas and niveau. Because stool cytotoxin assay for clostridium difficile was positive and colon fiberscopic examination showed a pseudomembrane at the left side of the colon, and a diagnosis of PMC was made. Treatment with intracolonic vancomycin administration by colonoscopy and nasoileus tube was successful. Physicians should take into account the possibility of bowel obstruction due to PMC occurring in patients undergoing chemotherapy and perform emergency colonoscopy examination of suspected cases.
Nomura
Kenichi
K
Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-0841, Japan. nomuken@koto.kpu-m.ac.jp
Fukumoto
Kohei
K
Shimizu
Daisuke
D
Okuda
Takashi
T
Yoshida
Naohisa
N
Kamitsuji
Yuri
Y
Matsumoto
Yosuke
Y
Konishi
Hideyuki
H
Ueda
Yuji
Y
Horiike
Shigeo
S
Okanoue
Takeshi
T
Taniwaki
Masafumi
M
D000208:Acute Disease; D002051:Burkitt Lymphoma / Q000150:complications*; D003113:Colonoscopy; D003937:Diagnosis, Differential; D003967:Diarrhea; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications*