Clostridium difficile colitis

Case contributed by Dr Vikas Shah


Recent lower respiratory tract infection. Now has diarrhoea and abdominal pain.

Patient Data

Age: 75 years
Gender: Female

Circumferential thickening of the colon wall affecting the entire colon. The hasutra are also thickened. The lumen contains fluid faeces. The small bowel is not involved. There is a small volume of ascites. No free gas and no collections.

Known atrophic right kidney. No other significant abnormality.

Case Discussion

Pancolitis is usually due to infection or inflammatory bowel disease, and less commonly ischaemia. Multiple features here allow a radiological diagnosis of Clostridium difficile colitis to be made: recent treatment of a LRTI, no known history of IBD, and in particular, haustral thickening with ascites. This pattern of findings is seen relatively more frequently in this type of colitis. The haustral thickening sometimes leads to a finding known as the accordion sign.

The C. difficile toxin tests were subsequently found to be positive.

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Case information

rID: 55321
Case created: 29th Aug 2017
Last edited: 20th Nov 2017
Inclusion in quiz mode: Included

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