Pseudomembranous Colitis Presenting with Dual Colonic Perforation in a 15 Year Old Female- A Rare Case Rreport

Abstract

Pseudomembranous colitis is an undesirable complication of C difficle infection. C difficle, although a part of normal gut flora, can become a nuisance and cause varying degrees of colitis, given the opportunity of a conducive host environment. Pseudomembranous colitis is managed medically with metronidazole or vancomycin, but can progress to toxic megacolon in upto 3% of cases. This dire complication may necessitate surgical management and is associated with a high mortality rate. Our case is a 15 year old, otherwise healthy patient who presented with perforative peritonitis with septic shock and diagnosed with dual colonic perforations on exploratory laparotomy. Pathological analysis of the specimen suggested presence of pseudomembranous throughout the resected segment of the colon. We suggest considering PMC as a differential diagnosis in a complicated toxic megacolon, regardless of the age of the patient, duration of antibiotic therapy and underlying diagnosis, particularly when there is an obscure history and diagnostic uncertainty.