Clostridium difficile Colitis Mimicking Acute Peritonitis

Drapkin, Mark S.; Worthington, Michael; Chang, Te‐Wen; Razvi, Syed

doi:10.1001/archsurg.1985.01390350097021

Cited by 44 publications

(28 citation statements)

References 20 publications

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“…The ‘acute abdoman’ presentation accounted for 5.2% of all patients with C. difficile colitis at the authors’ institution during the period of their study [3]. More than 10 years later our incidence of laparotomy for C. difficile colitis mimicking ‘acute abdomen’ has been 4.3% (10/223).…”

Section: Discussionmentioning

confidence: 99%

“…In 1985, Drapkin et al [3]reported 5 patients who underwent a nontherapeutic laparotomy because of failure to diagnose C. difficile colitis as the cause of the clinical ‘acute abdomen’. The ‘acute abdoman’ presentation accounted for 5.2% of all patients with C. difficile colitis at the authors’ institution during the period of their study [3].…”

Section: Discussionmentioning

confidence: 99%

“…In 1985 Drapkin et al [3]reported 5 patients in whom C. difficile colitis mimicked acute peritonitis, leading to unnecessary laparotomies. The notion that C. difficile colitis may occasionally present as an ‘acute abdomen’ has subsequently been sporadically mentioned [4], but has probably not been sufficiently emphasized.…”

Section: Introductionmentioning

confidence: 99%

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Acute Abdomen and <i>Clostridium difficile</i> Colitis: Still a Lethal Combination

Klipfel

Schein²,

Fahoum³

et al. 2000

Dig Surg

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Background: With the steadily prevalent appropriate and inappropriate use of antimicrobial agents, Clostridium difficile colitis has continued to be noticed as a common problem in hospitalized patients. The aim of this communication is to highlight a subset of C. difficile colitis patients who presented with an acute abdomen. Methods: This is a retrospective study of 10 patients who underwent laparotomy for an ‘acute abdomen’ with an intraoperative or postoperative diagnosis of C. difficile colitis. Results: All patients received antibiotics (mean 9.5 days) for other illnesses. The mean APACHE II score was 18.8 (range 8–25) and the mortality rate was 80%. Two patients had colostomies created. One patient underwent a subtotal colectomy, and another underwent a Hartmann procedure; the rest had a nontherapeutic procedure. Conclusion: We conclude that C. difficile colitis presenting as an ‘acute abdomen’ still represents a lethal entity. Patients who present with an ‘acute abdomen’, with a history of recent or current antibiotic intake, and without findings which mandate an exploration should have C. difficile colitis urgently excluded. Timely diagnosis of C. difficile colitis through bedside sigmoidoscopy or a CT scan could spare the critically ill patient an unneccessary and risky operation. Furthermore, if laparotomy is subsequently needed then having a preoperative diagnosis of C. difficile colitis will allow appropriate surgical therapy to be implemented.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute Abdomen and <i>Clostridium difficile</i> Colitis: Still a Lethal Combination

Klipfel

Schein²,

Fahoum³

et al. 2000

Dig Surg

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“…In one series, a twoyear institutional study of CDI revealed that "acute abdomen" was the presenting feature in 5% of patients with CDI, with 2 of 5 having no diarrhea prior to emergency laparotomy [32] . This acute abdomen presentation without diarrhea may be particularly confusing in the postoperative patient.…”

Section: Clinical Presentation Of CDImentioning

confidence: 99%

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

Oldfield

Johnson

2014

WJGPT

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Clostridium difficile infection (CDI) presents a rapidly evolving challenge in the battle against hospitalacquired infections. Recent advances in CDI diagnosis and management include rapid changes in diagnostic approach with the introduction of newer tests, such as detection of glutamate dehydrogenase in stool and polymerase chain reaction to detect the gene for toxin production, which will soon revolutionize the diagnostic approach to CDI. New medications and multiple medical society guidelines have introduced changing concepts in the definitions of severity of CDI and the choice of therapeutic agents, while rapid expansion of data on the efficacy of fecal microbiota transplantation heralds a revolutionary change in the management of patients suffering multiple relapses of CDI. Through a comprehensive review of current medical literature, this article aims to offer an intensive review of the current state of CDI diagnosis, discuss the strengths and limitations of available laboratory tests, compare both current and future treatments options and offer recommendations for best practice strategies.

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“…Historically, severe disease, such as toxic megacolon, as well as perforation, colectomy, and death, were infrequent events [4,5]. However, hospitals across North America and Europe have identified CD infection outbreaks in their facilities, with rates as high as 39.9 cases per 1000 hospital admissions [6].…”

mentioning

confidence: 99%

Asymptomatic Clostridium difficile Colonization: Is This the Tip of Another Iceberg?

Muto

2007

Clinical Infectious Diseases

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Clostridium difficile Colitis Mimicking Acute Peritonitis

Cited by 44 publications

References 20 publications

Acute Abdomen and <i>Clostridium difficile</i> Colitis: Still a Lethal Combination

Acute Abdomen and <i>Clostridium difficile</i> Colitis: Still a Lethal Combination

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

Asymptomatic Clostridium difficile Colonization: Is This the Tip of Another Iceberg?

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