[Rectoscopy: a useful tool to diagnose pseudomembranous colitis (author's transl)]

Area of Science:

• Gastroenterology
• Coloproctology

Context:

• Pseudomembranous colitis is a serious condition often associated with antibiotic use.
• Accurate and timely diagnosis is crucial for effective patient management.
• Differential diagnosis can be challenging, especially in cases with severe co-morbidities.

Purpose:

• To evaluate the diagnostic utility of rectosigmoidoscopy in cases of pseudomembranous colitis.
• To assess the accuracy of rectosigmoidoscopy compared to other diagnostic methods.
• To determine the indications for rectosigmoidoscopy in patients with suspected pseudomembranous colitis.

Summary:

• Rectosigmoidoscopy was performed in 14 cases of pseudomembranous colitis.
• The rectosigmoidoscopic appearance led to a correct diagnosis in 8 out of 9 cases.
• Biopsies confirmed the diagnosis in all cases.
• Rectosigmoidoscopy corrected misdiagnoses from digital rectal examination (suspected rectal tumors).
• In severe cases with mild symptoms, diagnosis was only confirmed post-mortem.
• The study advocates for systematic rectosigmoidoscopy with biopsies in antibiotic-treated patients with unexplained diarrhea or acute abdominal syndromes.

Impact:

• Rectosigmoidoscopy offers a high diagnostic yield for pseudomembranous colitis.
• Early diagnosis via rectosigmoidoscopy can prevent unnecessary invasive procedures like laparotomy.
• This diagnostic approach aids in differentiating pseudomembranous colitis from other conditions, such as rectal tumors.
• The findings support the integration of rectosigmoidoscopy into the diagnostic workup for specific patient populations.
• Improved diagnostic accuracy can lead to timely and appropriate treatment, potentially reducing morbidity and mortality.