[Treatment of a severe Clostridium difficile infection with colonic lavages. Report of one case]

Rev Med Chil. 2015 May;143(5):668-72. doi: 10.4067/S0034-98872015000500016.
[Article in Spanish]

Abstract

A loop ileostomy with intraoperative anterograde colonic lavage has been described as an alternative to colectomy in the management of cases of Clostridium difficile infection refractory to medical treatment. We report a 69 years old diabetic women admitted with a septic shock. An abdominal CAT scan showed a pan-colitis that seemed to be infectious. A polymerase chain reaction was positive for Clostridium Difficile. Due to the failure to improve after full medical treatment, a derivative loop ileostomy and intra-operatory colonic lavage were performed, leaving a Foley catheter in the proximal colon. In the postoperative period, anterograde colonic instillations of Vancomycin flushes through the catheter were performed every 6 hours. Forty eight hours after surgery, the patient improved. A colonoscopy prior to discharge showed resolution of the pseudomembranous colitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Animals
  • Clostridioides difficile*
  • Combined Modality Therapy / methods
  • Enterocolitis, Pseudomembranous / therapy*
  • Female
  • Humans
  • Ileostomy / methods*
  • Therapeutic Irrigation / methods*
  • Vancomycin / administration & dosage

Substances

  • Vancomycin