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Colostomy with vancomycin administration as an effective treatment for toxic megacolon associated with fulminant
Masashi Haraguchi1, Ko Komuta, Junichiro Furui
1Department of Surgery, Graduate School of Biochemical Sciences, Nagasaki University, Nagasaki, Japan. haraguci@mb.ejnet.ne.jp
Abstract:
We report a case of toxic megacolon associated with fulminant pseudomembranous colitis. A 72-year-old woman was admitted with severe dehydration and shock. Computed tomography showed evidence of diffuse thickening of the colonic wall, colonic dilatation and ascites. She underwent transverse colostomy and received postoperative vancomycin, both orally and by administration from the stoma. Her clinical situation improved dramatically following surgery. When a patient is unable to tolerate subtotal colectomy and ileostomy because of a severe overall condition, temporary colostomy followed by administration of vancomycin through the stoma is recommended.
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