BCM
Gastroenterology Grand Rounds - Take Home Lessons
The main lessons to take home concerning this case
are:
1. Toxic megacolon is a potentially lethal complication
of Clostridium difficile colitis, characterized by total or segmental
colonic dilatation associated with systemic toxicity.
2. Medical treatment with metronidazole or vancomycin
should be initiated as soon as possible, and subtotal colectomy is reserved
for those who do not respond to medical treatment within 48-72 hours or
those with a perforation.
3. There is insufficient data on endoscopic decompression
of toxic megacolon.
