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Pseudomembranous colitis without diarrhea presenting clinically as acute intestinal pseudo-obstruction
R A Sheikh1, S Yasmeen, M P Pauly
1Division of Gastroenterology/Hepatology, San Joaquin General Hospital, Stockton, CA95201, USA.
Journal of Gastroenterology
|October 2, 2001
Summary
Pseudomembranous colitis typically causes diarrhea. This case highlights an unusual presentation of Clostridium difficile infection causing obstipation and pseudo-obstruction in an elderly patient, successfully treated with metronidazole.
Area of Science:
- Gastroenterology
- Infectious Diseases
Background:
- Pseudomembranous colitis is commonly associated with antibiotic use and presents with diarrhea.
- Obstipation and colonic pseudo-obstruction are rare initial symptoms of this condition.
Observation:
- An elderly female patient with multiple comorbidities presented with fever, abdominal pain, distension, and obstipation, but no diarrhea.
- Initial conservative management for suspected bowel obstruction was unsuccessful.
Findings:
- Colonoscopy revealed characteristic pseudomembranes, and Clostridium difficile toxin assay was positive.
- The patient's symptoms resolved with metronidazole treatment, confirming the diagnosis of pseudomembranous colitis.
Implications:
- This case underscores the importance of considering Clostridium difficile infection in patients with atypical presentations of bowel obstruction.
- Early diagnosis and targeted therapy are crucial for favorable outcomes in pseudomembranous colitis, even with unusual symptoms.