Case Report
Fulminant Clostridium difficile Enteritis after Proctocolectomy and Ileal Pouch-Anal Anastamosis
Table 1
Previously
reported cases of small bowel C. difficile.
| | Author | Age | IBD | Intestinal operation | Recent hospitalization/operation | Recent Abx | ICU/Sepsis | OR | Endoscopy | Treatment | Death | Notes |
| 1 | LaMont and Trnka [4] 1980 | 23 | Crohn's | Partial colectomy | No | No | No | No | EGD—pseudomembranes in
duodenum | Vancomycin | No | 2 | Shortland et al. [5] 1983 | 70 | No | Ileal conduit | Yes | Yes | — | No | Sigmoidoscopy—pseudomembranes | Vancomycin | Yes | 3 | Testore et al. [6] 1984 | 69 | No | APR | Yes | Yes | Yes | No | — | — | Yes | 4 | Miller et al. [7] 1989 | 18 | No | — | Yes | Yes | Yes | Yes | Flexible sigmoidoscopy—inflammation; no pseudomembranes | Streptomycin | No | 2 jejunal perforations | 5 | Kuntz et al. [8] 1993 | 53 | UC | TAC | Yes | Yes | Yes | Yes | — | Vancomycin, flagyl | Yes | Intramural gas on CT | 6 | Tsutaoka et al. [9] 1994 | 66 | No | Rt hemicolectomy + APR | Yes | Yes | Yes | Yes | — | Vancomycin, flagyl | Yes | 7 | Yee et al. [10] 1996 | 71 | No | TAC | Yes | Yes | Yes | Yes | — | Flagyl | Yes | 8 | Kralovich
et al. [11] 1997 | 65 | No | Jejunal-ileal bypass | Yes | Yes | Yes | Yes | Flexible sigmoidoscopy—pseudomembranes | Vancomycin, flagyl | Yes | 9 | Vesoulis
et al. [12] 2000 | 56 | Crohn's | TPC | Yes | Yes | Yes | Yes | — | Flagyl | No | 10 | Freiler
et al. [13] 2001 | 26 | UC | TAC | Yes | Yes | No | No | — | Flagyl | No | 11 | Jacobs et al. [14] 2001 | 83 | — | — | Yes | Yes | — | Yes | — | — | No | 12 | Tjandra
et al. [15] 2001 | 60 | No | Sigmoid colectomy | Yes | Yes | Yes | Yes | Flexible sigmoidoscopy—pseudomembranes | Vancomycin, flagyl | Yes | 13 | Mann et al. [16] 2003 | 35 | UC | IPAA | No | No | No | No | Flexible endoscopy—inflammed, ulcerated mucosa | Vancomycin; resistant to flagyl | No | Chronic pouchitis | 14 | Hayetian et al. [17] 2006 | 80 | No | LAR | Yes | Yes | Yes | Yes | — | Flagyl | Yes | Ileal perforation | 15 |
Hayetian et al. [17] 2006 | 83 | No | None | Yes | Yes | Yes | Yes | — | Vancomycin, flagyl | No | Ileal perforation | 16 | Kim et al. [18] 2007 | 65 | Crohn's | TPC | Yes | Yes | Yes | No | — | Flagyl | Yes | 17 | Lundeen et al. [3]
(6 patients) 2007 | Mean 35.3 | UC (6 patients) | 3 IPAA3 TAC | 6/6 | 6/6 | 1/6 | 1/6 | — | Vancomycin, flagyl | No | 18 | Wood et al. [19] 2008 | 48 | UC | IPAA | Yes | Yes | Yes | Yes | Flexible endoscopy—normal pouch | Flagyl | No | 19 | Follmar et al. [20] 2008 | 49 | UC | IPAA | Yes | Yes | No | Yes | — | Vancomycin, resistant to
flagyl | No | Or–mesh removal | 20 | Fleming et al. [21] 2008 | 54 | UC | TAC | Yes | Yes | ? | No | — | Flagyl, vancomycin, rifampin | No | 21 | Yafi et al. [22] 2008 | 21 | UC | TAC | Yes | Yes | ? | Yes | — | Vancomycin | No | Pelvic abscess |
| | Total | 50.3 | 16/26 | 23/26 | 24/26 | 24/26 | 13/26 | 14/26 | 7/26 | 21/26 | 9/26 |
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