Korean J Gastrointest Endosc > Volume 36(2); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;36(2): 112-116.
독성 거대결장과 패혈증 소견을 보인 전격성 위막성 대장염 1예
고동희ㆍ이항락ㆍ김정미ㆍ문원ㆍ이오영ㆍ윤병철ㆍ최호순ㆍ함준수ㆍ박찬금*
한양대학교 의과대학 내과학교실, *병리학교실
A Case of Toxic Megacolon Associated with Fulminant Pseudomembranous Colitis
Dong Hee Koh, M.D., Hang Lak Lee, M.D., Jung Mi Kim, M.D., Won Moon, M.D., Oh Young Lee, M.D., Byung Chul Yoon, M.D., Ho Soon Choi, M.D., Joon Soo Hahm, M.D. and Chan Kum Park, M.D.*
Departments of Internal Medicine and *Pathology, Hanyang University College of Medicine, Seoul, Korea
Abstract
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. (Korean J Gastrointest Endosc 2008;36:112-116)
Key Words: Toxic megacolon, Clostridium difficile, Pseudomembraneous colitiss
주요어: 독성 거대 결장, Clostridium difficile, 위막성 대장염
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