[Toxic megacolon secondary to Clostridium difficile-associated pseudomembranous colitis].
A 78-year-old male without pre-existing comorbidity who underwent revision of a hip arthroplasty developed abdominal pain and distension, diarrhoeas, pyrexia and leucocytosis after only 5 days' postoperative treatment with cefuroxime and gentamycine. Abdominal computed tomography demonstrated severe colonic dilation, inflammation and oedema consistent with toxic megacolon. Stool samples were positive for Clostridium difficile. Oral vancomycine treatment and colonic decompression were inefficient. Subtotal colectomy was performed after which the condition improved.
Rasmussen
Torsten Bloch
TB
Arhus Universitetshospital, Arhus Sygehus, Kirurgisk Afdeling P. torstenbr@dadlnet.dk
Friis
Mikkel Lønborg
ML
Lehnhoff
Rudolf
R
Tøttrup
Anders
A
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip; D002444:Cefuroxime / Q000008:administration & dosage; D003082:Colectomy; D003937:Diagnosis, Differential; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008532:Megacolon, Toxic / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002444:Cefuroxime