A Novel Surgical Treatment for Pediatric Fulminant <i>Clostridium Difficile</i> Colitis.

Abstract

Pediatric patients rarely present with severe, complicated <i>Clostridium difficile</i> colitis. The medical and surgical management of pediatric patients is primarily based on evidence from adult populations, in which standard therapy often includes subtotal colectomy and end ileostomy. New evidence in adults suggests that a diverting loop ileostomy and colonic lavage is an effective alternative for the management of refractory severe, complicated <i>C difficile</i> colitis. We report the case of a 15-year-old female patient who developed severe, complicated <i>C difficile</i> colitis. After failing medical management, she underwent a diverting loop ileostomy with antegrade colonic lavage and recovered uneventfully. There is limited literature on the medical management of <i>C difficile</i>–associated disease in pediatric patients and even less information on the medical or surgical management of severe, complicated <i>C difficile</i> colitis in pediatrics. Diverting loop ileostomy and colonic lavage should be considered as an alternative to subtotal colectomy and end ileostomy in a pediatric patient with severe, complicated <i>C difficile</i> colitis.