BCM Gastroenterology Grand Rounds - Take Home Lessons

The main lessons to take home concerning this case are:

 

1. A partially obstructing colon cancer can very rarely present as fulminant C. difficile colitis.

2. Indications for a subtotal colectomy for fulminant C. difficile colitis include severe cases that are not responding to maximal medical therapy that have life-threatening systemic symptoms or toxic complications of the colitis such as toxic megacolon, uncontrolled bleeding, and perforation.

3. Emergency surgery for colon cancer has a higher operative mortality compared to elective surgery for colon cancer. However, if the patient survives the surgery the long-term mortality is similar to age and cancer stage matched controls.