Fulminant Clostridium difficile enteritis causing abdominal compartment syndrome.
BACKGROUND
Clostridium difficile infection of the small bowel, or C. difficile enteritis (CDE), is an uncommon condition. Cases reported previously have been described in patients with inflammatory bowel disease (IBD), compromised immune systems, or a history of colectomy or small bowel surgery.


METHODS
We present a case of fulminant CDE causing abdominal compartment syndrome following a routine outpatient inguinal hernia repair. This patient developed multiple organ failure dysfunction syndrome requiring surgical abdominal decompression and a small bowel resection. This case highlights the challenges in the diagnosis of CDE, particularly in patients with intact colons and unusual presentations.


CONCLUSIONS
A high index of suspicion is required, as early recognition of CDE is essential in reducing morbidity and mortality. This case report is followed by a review of the current literature on CDE, with a focus on the complexities inherent in the identification of this problem and the decision-making process for surgical intervention.
1 Department of General Surgery, Cleveland Clinic , Cleveland, Ohio.
Hue
H
Thai
Alfredo D
AD
Guerron
Kalman P
KP
Bencsath
Xiuli
X
Liu
Michele
M
Loor
D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000150:complications*; D004751:Enteritis / Q000150:complications*; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged