Colonic decompression and direct intraluminal medical therapy for Clostridium difficile‐associated megacolon using a tube placed endoscopically in the proximal colon

Aim Urgent colectomy for severe Clostridium difficile infection can be associated with increased morbidity and mortality. We aimed to use endoscopic methods for treatment. Method We describe a technique of placing an intracolonic tube facilitating decompression and direct delivery of vancomycin to the proximal colon along with enemas on a regular and frequent basis that may not be possible with vancomycin enemas alone. Results Successful resolution of the C. difficile infection and avoidance of surgery. Conclusion While further long-term evaluation is required, our initial results have shown it to be effective in treating select patients with recalcitrant Clostridium difficile-associated megacolon.