The Surgical Management of Complicated Clostridium Difficile Infection: Alternatives to Colectomy

Abstract

Background: Clostridium difficile is the most common nosocomial infection in the United States. There is a subset of patients for whom medical therapy fails or who progress rapidly to the development of complicated disease, often marked by critical systemic illness. Patients with complicated Clostridium difficile infection (CDI) who progress or fail to improve benefit from surgery.

Results: This focused review highlights the importance of early surgical consultation for patients with complicated CDI, as well as emerging surgical therapy that does not involve resection of the colon but rather the creation of a loop ileostomy with colonic lavage, followed by antegrade vancomycin enemas into the colon during the post-operative period.