Clostridium difficile colitis - a role of surgery

Clostridium difficile infection (CDI) is the most frequent cause of nococomial diarrhoea. Most cases are succesfully treated by antibiotic therapy, but nearly 10% may progress to the fulminant form. The aim of this work is a retrospective evaluation of the results of surgical treatment of patients with the severe Costridium colitis, in the period 2008-2014. Clostridium toxins were detected in patients in Bohunice University Hospital in 1956. Thirty seven of them underwent surgery due to toxic colitis. There were 6 total colectomies with terminal ileostomy, 29 subtotal colectomies with terminal ileostomy, 1 coecostomy and 1 axial ileostomy. The 30-day mortality was nearly 35 %, 90- day mortality 54% and morbidity 89%. Early and precise indication for surgery could save about 65% of patients with fulminant course of Clostridium difficile colitis.