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Pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric Burkitt

Kenichi Nomura1, Kohei Fukumoto, Daisuke Shimizu

  • 1Department of Molecular Hematology and Oncology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-0841, Japan. nomuken@koto.kpu-m.ac.jp

World Journal of Gastroenterology
|April 26, 2005
PubMed

Insights

Pseudomembranous colitis (PMC) can cause bowel obstruction without diarrhea, especially in chemotherapy patients. Early diagnosis via colonoscopy is crucial for successful treatment.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Oncology

Background:

  • Pseudomembranous colitis (PMC) is typically associated with fever and diarrhea in patients receiving systemic antibiotics.
  • Chemotherapy for conditions like Burkitt lymphoma can increase susceptibility to gastrointestinal complications.

Observation:

  • A 60-year-old male undergoing chemotherapy for gastric Burkitt lymphoma presented with fever and abdominal pain.
  • Initial radiography revealed intestinal gas and fluid levels, suggesting obstruction.
  • Diagnostic tests confirmed Clostridium difficile infection and pseudomembranes in the colon.

Findings:

  • The patient exhibited intestinal obstruction as a primary symptom of PMC, notably without diarrhea.
  • Intracolonic vancomycin delivered via colonoscopy and a nasoileus tube proved effective.
  • This case highlights an atypical presentation of PMC.

Implications:

  • Physicians must consider bowel obstruction due to PMC in chemotherapy patients, even without typical diarrheal symptoms.
  • Prompt emergency colonoscopy is recommended for suspected cases to ensure timely diagnosis and treatment.
  • This underscores the importance of vigilant monitoring for gastrointestinal complications during cancer therapy.

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