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Related Experiment Videos

Acute abdomen and Clostridium difficile colitis: still a lethal combination.

A A Klipfel1, M Schein, B Fahoum

  • 1New York Methodist Hospital, Brooklyn, NY 11215, USA.

Digestive Surgery
|April 27, 2000
PubMed
Summary

Clostridium difficile colitis presenting as an acute abdomen is a lethal condition. Early exclusion of C. difficile colitis in patients with acute abdomen and recent antibiotic use can prevent unnecessary surgery.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Clostridium difficile colitis is a common problem in hospitalized patients, often linked to antimicrobial use.
  • A subset of patients present with an acute abdomen, posing diagnostic and therapeutic challenges.

Purpose of the Study:

  • To highlight the characteristics and outcomes of patients with Clostridium difficile colitis presenting as an acute abdomen.
  • To emphasize the importance of timely diagnosis and appropriate surgical management.

Main Methods:

  • Retrospective study of 10 patients who underwent laparotomy for an acute abdomen.
  • Diagnosis of C. difficile colitis was confirmed intraoperatively or postoperatively.

Main Results:

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  • All patients had received recent antibiotic therapy.
  • The mean APACHE II score was 18.8, with a high mortality rate of 80%.
  • Surgical interventions ranged from colostomies to subtotal colectomies, with most procedures being nontherapeutic.

Conclusions:

  • C. difficile colitis presenting as an acute abdomen remains a lethal entity.
  • Urgent exclusion of C. difficile colitis is recommended for patients with acute abdomen and recent antibiotic history.
  • Timely diagnosis via sigmoidoscopy or CT scan can prevent unnecessary exploratory surgery and guide appropriate treatment.