No abstract available.
Enteritis* ; Megacolon, Toxic* ; Salmonella*

The clinical presentation of Clostridium difficile infection ranges from asymptomatic carriage, colitis with or without pseudomembranes, to fulminant colitis. Although not common, fulminant Clostridium difficile colitis can result in bowel perforation and peritonitis with a high mortality rate. We report a case of toxic megacolon associated with fulminant pseudomembranous colitis. We experienced a case of a 65-year-old male patient who presented with abdominal distension and pain for three days during treatment of pneumonia. We were able to diagnose the case as a toxic megacolon associated with fulminant pseudomembranous colitis. In spite of oral metronidazole treatment and conservative treatment, the clinical course worsened and the patient went into septic shock. The patient underwent a total colectomy but the clinical situation did not improve and the patient died.
Aged ; Clostridium difficile ; Colectomy ; Colitis ; Enterocolitis, Pseudomembranous ; Humans ; Male ; Megacolon, Toxic ; Metronidazole ; Peritonitis ; Pneumonia ; Shock, Septic

Cytomegalovirus (CMV) infection is associated with significant morbidity and mortality in immunocompromised patients. It may cause serious illness including bleeding, ulceration and perforation of the gastrointestinal tract. However, bowel perforation, toxic megacolon, and massive lower gastrointestinal bleeding caused by CMV in one patient is not common. In this report, we present a case of CMV colitis causing cecal perforation and massive lower gastrointestinal bleeding in a patient with lupus nephritis. In our case, severe lower gastrointestinal bleeding developed during successful treatment of CMV infection with ganciclovir. Even though the outcome of CMV colitis has improved since ganciclovir has been available for immunocompromised patients, reductions in gastrointestinal bleeding from colonic ulcers of CMV colitis may be possible during successful treatment with ganciclovir. This case suggests the possibility of lower gastrointestinal bleeding from a colon ulcer of CMV colitis should be considered during successful treatment with ganciclovir in immunocompromised patients.
Colitis ; Colon ; Cytomegalovirus ; Ganciclovir ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Immunocompromised Host ; Lupus Nephritis ; Megacolon, Toxic ; Ulcer

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Drug Therapy* ; Humans ; Lung Diseases, Interstitial* ; Megacolon, Toxic* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Amyloidosis is characterized by extracellular deposition of protein fibrils in one or multiple organs. AA amyloidosis is secondarily occurred to be related with chronic infections or inflammatory diseases. We report a 67-year-old man suffered from secondary AA amyloidosis related with chronic Clostridium difficile colitis after repeated total hip replacement surgery. Infection control is the most important treatment of AA amyloidosis secondary to chronic infection. However, the patient's C. difficile colitis was not controlled well, eventually toxic megacolon with sepsis was developed. Consequently, he had to take total colectomy, but he expired with multi-organ failures. We suggested that early surgical procedure might be one option for intractable C. difficile colitis complicated with secondary amyloidosis.
Aged ; Amyloidosis* ; Arthroplasty, Replacement, Hip ; Clostridium difficile* ; Clostridium* ; Colectomy ; Colitis* ; Humans ; Infection Control ; Megacolon, Toxic* ; Sepsis

Cytomegalovirus is a frequent opportunistic pathogen in immunosuppressed patients and CMV colitis is one of its major complications. It usually presents as gastrointestinal ulceration with bleeding or perforation, but it can also take less common forms resembling many other entities, including viral gastroenteritis, ischemic colitis, intestinal pseudo-obstuction, toxic megacolon. We experienced a 49-year-old man with symptom of severe constipation and lower abdominal pain. He was diagnosed as having focal segmental glomerulosclerosis by renal biopsy, but he was an immunocompetent state. An abdominal X-ray showed marked dilatation of descending colon without air-fluid level. At colonoscopy and biopsy, he was diagnosed as having CMV colitis with focal stenosis. Treatment for two weeks with ganciclovir resulted in resolution of colitis, but stenosis was remained. We report a case of toxic megacolon and focal stenosis due to CMV colitis in a FSGS patient. It was not certain whether FSGS was related with immunosuppressive state.
Abdominal Pain ; Biopsy ; Colitis* ; Colitis, Ischemic ; Colon, Descending ; Colonoscopy ; Constipation ; Constriction, Pathologic ; Cytomegalovirus* ; Dilatation ; Ganciclovir ; Gastroenteritis ; Glomerulosclerosis, Focal Segmental* ; Hemorrhage ; Humans ; Megacolon ; Megacolon, Toxic* ; Middle Aged ; Ulcer

Toxic megacolon is a devastating complication of colitis, which is commonly caused by inflammatory bowel disease. Frequently reported complications of toxic megacolon are bleeding, sepsis, colon perforation, and shock. Herein, we report a rare case of cardiac arrest that was likely caused by toxic megacolon in a 49-year-old male, who experienced 3 months of intermittent dyspnea and abdominal distension that abruptly worsened before presentation. Our case suggests that severe colon dilation complicated by toxic megacolon, especially accompanied by cardiopulmonary symptoms and signs, has the potential to progress to an abdominal compartment syndrome, which is a rare but life-threatening complication.
Colitis ; Colon* ; Critical Care ; Dyspnea ; Heart Arrest* ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intra-Abdominal Hypertension ; Male ; Megacolon ; Megacolon, Toxic ; Middle Aged ; Sepsis ; Shock

Clinical manifestations of Salmonella infection are variable such as enterocolitis, bacteremia, enteric fever, focal infection and asymptomatic carrier status. Among these presentations, enterocolitis is the most common clinical manifestation and can be diagnosed by the use of fecal specimens. Patients with severe infectious colitis are at increased risk of developing a colon perforation after colonoscopy due to colon trauma. We report a case of a 31-year-old woman with transverse colon perforation after colonoscopy that was diagnosed with enterocolitis caused by infection with non-typhoidal group D Salmonella.
Adult ; Bacteremia ; Colitis ; Colon ; Colon, Transverse ; Colonoscopy ; Enterocolitis ; Female ; Focal Infection ; Humans ; Megacolon, Toxic ; Salmonella ; Salmonella Infections ; Typhoid Fever

Toxic megacolon is a rare clinical complication of fulminant Clostridium difficile infection. The mortality rate of fulminant C. difficile infection is reported to be as high as 50%. Fecal microbiota transplantation is a highly effective treatment in patients with recurrent or refractory C. difficile infection. However, there are few published articles on the use of such transplantation for fulminant C. difficile infection. Here, we report on a patient with toxic megacolon complicated by C. difficile infection who was treated successfully with fecal microbiota transplantation.
Aged ; *Clostridium difficile ; Enterocolitis, Pseudomembranous/*complications ; Fecal Microbiota Transplantation/*methods ; Feces/*microbiology ; Humans ; Male ; Megacolon, Toxic/*microbiology/*therapy

Ulcerative colitis produces repeated improvements and relapses of chronic colonic inflammation. Complications of the disease can include bleeding, toxic megacolon, colon cancer, or colon stricture. While colonic strictures are common in Crohn's disease, this complication rarely appears in ulcerative colitis cases. Unlike in Crohn's disease, where strictures are commonly treated by endoscopic balloon dilatation, surgical management is the basis for treatment of strictures in ulcerative colitis because malignant strictures are common and because the stricture region is generally wide. We report the case of a patient who presented with decreased stool caliber while undergoing treatment for ulcerative colitis. We performed therapeutic balloon dilatation in this patient with a benign stricture caused by ulcerative colitis and experienced improvement of symptoms.
Colitis, Ulcerative ; Colon ; Colonic Neoplasms ; Constriction, Pathologic ; Crohn Disease ; Dilatation ; Hemorrhage ; Humans ; Inflammation ; Megacolon, Toxic ; Recurrence ; Ulcer