Toxic Megacolon in a Patient with Clostridium Difficile Infection with Diverticulitis. Case Report

Abstract

Toxic megacolon is a fatal condition defined as a rare, life-threatening, acute colonic dilatation of colitis. The case of a 41-year-old male with a history of irritable bowel syndrome is presented, who starts with diarrhea on more than 20 occasions accompanied by blood and mucus, emesis is added, and a fever of 39°C. Laboratories with hemoglobin 8.1g/dL, positive clostridium difficile toxin AB, positive glutamate dehydrogenase, simple abdominal tomography with distended intestinal loops, and presence of rectovesical fistula, performing total colectomy with ileostomy reporting ischemic colitis, perforation with ulcerated areas and pseudopolyps. Continued with well tolerated feeding. There are case reports of megacolon as a complication of inflammatory bowel disease and clostridium difficile infection. Total colectomy plus ileostomy is the surgical procedure of choice when conservative treatment fails. Inflammatory bowel pathology can show in its spectrum various clinical characteristics of debut or evolution, so a multidisciplinary approach and management must be taken from the diagnosis.