A Case of Pseudomembranous Enteritis Presented with Chemotherapy and Needed Small Bowel Resection

Abstract

A 71-year-old man underwent laparoscopic abdominoperineal resection with a diagnosis of rectal cancer and the pathological diagnosis of pT3N1M0, Stage IIIb was made. The adjuvant chemotherapy (Cape OX regimen) was started. Nine days after initiation of the chemotherapy, it was suspended for diarrhea. On the 17^th day the patient presented to our hospital and was diagnosed with infectious enteritis associated with the chemotherapy. Enteritis improved with conservative therapy, but the patient had recurrent episodes of enteritis and finally developed constant intestinal obstruction. We thus decided to perform surgery. Before surgery, Clostridioides difficile (CD) toxin was negative. The lesion was localized in the ileum and partial small bowel resection was performed. Histopathological examination of the resected specimen confirmed formation of pseudomembrane on the mucosal surface, leading to the diagnosis of pseudomembranous enteritis. His postoperative course was uneventful and he was discharged on 14^th postoperative day. It is comparatively rare that pseudomembranous enteritis arises in the small intestine, and further rarer that it presents with chemotherapy and needs surgery. Our case with a review of the literature is reported here.