Colonic decompression and direct intraluminal medical therapy for Clostridium difficile-associated megacolon using a tube placed endoscopically in the proximal colon.

Abstract

AIM:

Urgent colectomy for severe Clostridium difficile infection can be associated with increased morbidity and mortality. We aimed to use endoscopic methods for treatment.

METHOD:

We describe a technique of placing an intracolonic tube facilitating decompression and direct delivery of vancomycin to the proximal colon along with enemas on a regular and frequent basis that may not be possible with vancomycin enemas alone.

RESULTS:

Successful resolution of the C. difficile infection and avoidance of surgery.

CONCLUSION:

While further long-term evaluation is required, our initial results have shown it to be effective in treating select patients with recalcitrant Clostridium difficile-associated megacolon.

• Authors: M W Causey, A Walker, M Cummings, E K Johnson, J A Maykel, S Steele
• Journal: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (Colorectal Dis) Vol. 16 Issue 2 Pg. O71-4 (Feb 2014) ISSN: 1463-1318 [Electronic] England
• PMID: 24134562 (Publication Type: Journal Article)
• Copyright: Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Chemical References

• Anti-Bacterial Agents
• Vancomycin

Topics

• Administration, Topical
• Anti-Bacterial Agents (therapeutic use)
• Clostridioides difficile
• Colonoscopy (methods)
• Decompression, Surgical (methods)
• Enema
• Enterocolitis, Pseudomembranous (complications, drug therapy)
• Humans
• Intubation, Gastrointestinal (methods)
• Megacolon (etiology, surgery)
• Vancomycin (therapeutic use)