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Case Reports
. 2005 May 7;11(17):2681-3.
doi: 10.3748/wjg.v11.i17.2681.

Pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric Burkitt lymphoma

Kenichi Nomura  1 , Kohei Fukumoto, Daisuke Shimizu, Takashi Okuda, Naohisa Yoshida, Yuri Kamitsuji, Yosuke Matsumoto, Hideyuki Konishi, Yuji Ueda, Shigeo Horiike, Takeshi Okanoue, Masafumi Taniwaki
Affiliations
Case Reports

Pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric Burkitt lymphoma

Kenichi Nomura et al. World J Gastroenterol. .

Abstract

Pseudomembranous colitis (PMC) usually manifests as fever and diarrhea in hospitalized patients treated with systemic antibiotics. We described a case of PMC with intestinal obstruction but without diarrhea. A 60-year-old man was hospitalized for chemotherapy for the treatment of Burkitt lymphoma of the stomach. The patient became febrile and complained of crampy abdominal pain during the post-chemotherapy nadir. Plain abdominal radiography showed some intestinal gas and niveau. Because stool cytotoxin assay for clostridium difficile was positive and colon fiberscopic examination showed a pseudomembrane at the left side of the colon, and a diagnosis of PMC was made. Treatment with intracolonic vancomycin administration by colonoscopy and nasoileus tube was successful. Physicians should take into account the possibility of bowel obstruction due to PMC occurring in patients undergoing chemotherapy and perform emergency colonoscopy examination of suspected cases.

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Figures

Figure 1
Figure 1
CT showing swelling of the wall of the left side of the transverse colon.
Figure 2
Figure 2
Plain radiography showing air-fluid levels and marked distention of bowel loops.
Figure 3
Figure 3
Pseudomembrane in the transverse colon.
See this image and copyright information in PMC

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