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Subtotal colectomy for refractory pseudomembranous enterocolitis

W C Boyd, L DenBesten

    JAMA
    |January 12, 1976
    PubMed

    Insights

    Pseudomembranous enterocolitis, often caused by antibiotics like clindamycin, may not improve with medication. Surgical intervention, specifically subtotal colectomy with ileostomy, can lead to recovery in severe cases.

    Area of Science:

    • Gastroenterology
    • Surgical Gastroenterology
    • Infectious Diseases

    Background:

    • Antibiotic-associated pseudomembranous enterocolitis (A-APEC) is a serious gastrointestinal condition.
    • Severe A-APEC can be refractory to medical management, including antibiotics and supportive care.
    • Clindamycin and lincomycin hydrochloride monohydrate are known causative agents.

    Observation:

    • Two critically ill patients with A-APEC were described.
    • These patients did not respond to conventional medical and drug therapies.
    • Their condition was life-threatening, necessitating alternative treatment strategies.

    Findings:

    • Both patients underwent subtotal colectomy with ileostomy.
    • Following the surgical intervention, both patients demonstrated complete recovery.
    • This suggests surgical management as a viable option for refractory A-APEC.

    Implications:

    • Subtotal colectomy with ileostomy may be a life-saving option for patients with severe, medically refractory pseudomembranous enterocolitis.
    • This surgical approach offers an alternative when antibiotic therapy and intensive medical support fail.
    • Further research into surgical indications and outcomes for A-APEC is warranted.

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