Abstract
A 75-year-old woman who underwent an orthopedic operation for lumbar vertebral canal stenosis was admitted to our hospital, because of abdominal distension, severe diarrhea, and developing sepsis. Colonoscopic examination showed a pseudomembrane in the colorectum, and Clostridium difficile toxin A was detected in the pseudomembrane. Vancomycin and metronidazole were administrated via a nasostmach tube and transanal tube for the pseudomembranous colitis, and intensive care for multiple organ dysfunctions were also performed. Because the patient had septic shock as well as developing multiple organ dysfunctions despite appropriate conservative therapy, an emergency laparotomy was carried out. The hugely distended colon with a highly edematous mesocolon was observed, and subtotal colectomy and ileostomy were performed. Immediately after the operation, the patient was recovering from the septic coma and respiratory dysfunction.The patient, however, died from acute respiratory dysfunction and progressive liver dysfunction on the 48 postoperative days. Surgical operation may be recommended as a therapeutic strategy for a pseudomembranous colitis with progressive multiple organ dysfunctions or septic shock.
