A Case of Severe Stenosis of the Colon due to Fulminant Clostridioides Difficile Colitis Treated by Subtotal Colectomy

Abstract

A 54-year-old man presented with abdominal pain and was diagnosed with portal venous gas. Because his vital signs were almost normal, and his clinical symptoms were mild, the portal venous gas was concluded to be due to the administration of α-glucosidase inhibitors (AGI). The AGIs were discontinued, and he was placed on antibiotics therapy. Although the condition quickly disappeared, he developed Clostridioides difficile (CD) colitis. He developed toxic megacolon later and was admitted to our hospital for surgery. After admission the inflammation and ulcerations of the transverse colon improved ; however, the stenosis progressively worsened, with a risk of causing complete intestinal obstruction. Subtotal colectomy was thus performed. Histopathological examination confirmed the diagnosis of colonic stenosis secondary to infectious colitis (probably a consequence of CD infection). Hitherto, three years and three months after the operation, he has not had any recurrence. We must keep in mind that intestinal obstruction can occur with CD colitis.