INTRODUCTION: Pseudomembranous colitis, also known as a Clostridium difficile colitis is a potentially life-threatening acute infectious colitis. This colitis results from the effects of toxins produced by the overgrowth of Clostridium difficile, usually as a result of broad-spectrum antibiotic therapy. Pseudomembranous colitis is characterized endoscopically by yellowish plaques forming pseudomembranes on the colonic mucosa.
CASE PRESENTATION: We are presenting a case of a 68-year-old woman who came to the Emergency Department in our hospital, complaining of abdominal tenderness, episodes of diarrhea, nausea and vomiting. She had elevated white blood cell count. The plain radiographic findings were not specific. The contrast-enhanced CT played a key role in establishing the diagnosis. The CT findings included: wall thickening of the entire colon with intense enhancement of the mucosa and extensive hypodensity of the submucosal layer due to oedema. Ascites was also present. The diagnosis of pseudomembranous colitis was later confirmed by the presence of toxins in stool assays. Very often, like in our case, Clostridium difficile colitis may present with symptoms suggestive of acute abdomen, which can lead to unwarranted laparotomy.
CONCLUSION: CT has been used increasingly in recent years for the evaluation of acute abdominal diseases. CT can be very helpful in suggesting the diagnosis of pseudomembranous colitis and thus avoid unwarranted laparotomy.
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