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Clin J Gastroenterol 2019 Feb 14. Epub 2019 Feb 14.

Third Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.

We report a case of community-acquired fulminant colitis caused by Clostridium difficile in Japan. A 46-year-old woman was diagnosed with severe infectious enterocolitis and was admitted at another hospital. The stool culture was positive for toxigenic C. Read More

J Clin Microbiol 2019 Feb 13. Epub 2019 Feb 13.

Department of Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, Quebec, Canada

The epidemiology of infection (CDI) has drastically changed since the emergence of the epidemic strain BI/NAP1/027, also known as ribotype 027 (R027). However, the relationship between the infecting strain and clinical outcomes is still debated. We hypothesized that certain subpopulations of R027 isolates could be associated with unfavorable outcomes. Read More

Acta Biomed 2018 Dec 17;89(9-S):153-157. Epub 2018 Dec 17.

Pediatric Emergency Unit, University Hospital of Parma, Maternal and Infant Department, Parma, Italy.

Background: Shiga-toxin Escherichia coli productor (STEC) provokes frequently an important intestinal damage that may be considered in differential diagnosis with the onset of Inflammatory Bowel Disease (IBD). The aim of this work is to review in the current literature about Hemolytic Uremic Syndrome (HUS) and IBD symptoms at the onset, comparing the clinical presentation and symptoms, as the timing of diagnosis and of the correct treatment of both these conditions is a fundamental prognostic factor. A focus is made about the association between typical or atypical HUS and IBD and a possible renal involvement in patient with IBD (IgA-nephropathy). Read More

Biomol NMR Assign 2018 Oct 28. Epub 2018 Oct 28.

Department of Chemistry, The University of Texas Rio Grande Valley, Edinburg, TX, USA.

Clostridium difficile is a gram-positive, toxin-producing, anaerobic bacterium whose virulence factors and mechanisms of pathogenesis require further investigation. C. difficile infections (CDI) result in the severe and potentially fatal gastrointestinal diseases pseudomembranous colitis and toxic megacolon following extensive broad spectrum antibiotic treatment. Read More

Wounds 2018 Oct;30(10):E102-E104

Department of Surgery, Swedish Medical Center, Seattle, WA.

Introduction: Aspergillus is a rare cause of surgical site infection most often seen in immunocompromised patients undergoing cardiac, transplant, ophthalmologic, or burn operations; an unusual case following a colon resection is presented here.

Case Report: The authors report a case of an invasive Aspergillus fumigatus infection following a subtotal colectomy for toxic megacolon. The patient was on antibiotics following the operation and chronic immunosuppression with steroids and infliximab. Read More

BMJ Case Rep 2018 Sep 30;2018. Epub 2018 Sep 30.

Department of Diagnostic Imaging, Hospital Tuanku Ja'afar Seremban, Seremban, Malaysia.

BMC Anesthesiol 2018 Sep 27;18(1):133. Epub 2018 Sep 27.

University Department for Cardiac Surgery, Heart Center Leipzig, Struempellstr. 39, 04289, Leipzig, Germany.

Background: Clostridium difficile (CD) is the most common pathogen causing nosocomial diarrhea. The clinical presentation ranges from mild diarrhea to severe complications, including pseudomembranous colitis, toxic megacolon, sepsis, and multi-organ failure. When the disease takes a fulminant course, death ensues rapidly in severe and complex cases. Read More

Viruses 2018 09 23;10(10). Epub 2018 Sep 23.

Department of Medicine, Divisions of Cardiovascular Medicine and Rheumatology, University of Florida, Gainesville, FL 32610-0277, USA.

Inflammatory bowel disease (IBD) and infection cause gastrointestinal (GI) distension and, in severe cases, toxic megacolon with risk of perforation and death. Herpesviruses have been linked to severe GI dilatation. MHV-68 is a model for human gamma herpesvirus infection inducing GI dilatation in interleukin-10 (IL-10)-deficient mice but is benign in wildtype mice. Read More

Medicine (Baltimore) 2018 Sep;97(38):e12315

University of Medicine and Pharmacy of Tirgu Mures, Tirgu Mures, Romania.

Rationale: Hirschsprung disease (HD) or colonic aganglionosis is a congenital disorder, which results from the abnormal migration of neuronal cells of the neural crest leading to a disorder of the enteric nervous system consisting in the absence of ganglion cells within the submucosal and myenteric plexus.

Patient Concerns: We report the case of a 7-month-old female infant admitted in our clinic for constipation and failure to thrive. At the age of 6 months, she was examined in our clinic for the same reasons, and we recommended symptomatic treatment without improvements. Read More

Respirol Case Rep 2018 Oct 31;6(7):e00360. Epub 2018 Aug 31.

Department of Medicine Queen Mary Hospital Hong Kong China.

We report the first case of toxic megacolon associated with afatinib use, which is a potentially fatal complication, with risks of colonic perforation. In this case, the condition improved on stopping afatnib. Clinicians need to be alert of this rare but fatal adverse effect and to avoid anti-diarrhoeal agents, which can worsen toxic megacolon. Read More

Eur J Clin Microbiol Infect Dis 2018 Dec 3;37(12):2293-2299. Epub 2018 Sep 3.

Service de Biologie, Unité de Microbiologie, Centre Hospitalier de Versailles, Le Chesnay, France.

Our aim was to study Clostridium difficile infection (CDI) in peripartum women in France and compare them to cases published in the literature. We characterize these infections regarding clinico-biological features and specific risk factors in order to raise awareness for obstetricians and midwifes. Eight antepartum and six post-partum CDI cases were retrospectively studied in 6 French centers during the period between 2008 and 2013. Read More

Gastroenterol Rep (Oxf) 2018 Aug 28;6(3):157-166. Epub 2018 Jun 28.

General Surgery Department, Liverpool Hospital, Elizabeth St, Liverpool, NSW, Australia.

is a major cause of hospital-associated diarrhoea, and in severe cases leads to pseudomembranous colitis and toxic megacolon. The frequency of infection (CDI) has increased in recent decades, with 453 000 cases identified in 2011 in the USA. This is related to antibiotic-selection pressure, disruption of normal host intestinal microbiota and emergence of antibiotic-resistant strains. Read More

Front Microbiol 2018 7;9:1843. Epub 2018 Aug 7.

Institute of Medical Microbiology, University Medical Center Göttingen Göttingen, Germany.

infections (CDI) are considered worldwide as emerging health threat. Uptake of spores may result in asymptomatic carrier status or lead to CDI that could range from mild diarrhea, eventually developing into pseudomembranous colitis up to a toxic megacolon that often results in high mortality. Most epidemiological studies to date have been performed in middle- and high income countries. Read More

Curr Microbiol 2018 Aug 6. Epub 2018 Aug 6.

Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, 141, Stockholm, Sweden.

Clostridium difficile is normally present in low numbers in a healthy adult gastro-intestinal tract (GIT). Drastic changes in the microbial population, e.g. Read More

Intern Emerg Med 2018 09 2;13(6):837-838. Epub 2018 Aug 2.

Clinica Medica I, Department of Internal Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, 27100, Italy.

Front Med (Lausanne) 2018 17;5:176. Epub 2018 Jul 17.

All India Institute of Medical Sciences, New Delhi, India.

In an interesting investigation by Khoury-Hanold et al. (1), genital infection of mice with herpes simplex virus 1 (HSV1) were reported to cause multiple pelvic organ involvement and obstruction. A small subset of mice succumbed after the first week of HSV1 infection. Read More

Cureus 2018 May 30;10(5):e2710. Epub 2018 May 30.

Graduate, Pontifical Catholic University of Ecuador, Chagrin Falls, USA.

Crohn's disease (CD) is a granulomatous inflammatory disease that can involve any part of the gastrointestinal tract, from mouth to anus. In most cases, it remits and relapses in the terminal ileum, requiring treatment via steroid boluses. In rare cases, however, CD can involve the pulmonary system presenting as dyspnea on exertion and dry cough. Read More

BMJ Case Rep 2018 Jul 26;2018. Epub 2018 Jul 26.

General Surgery, NYU Langone Medical Center, Brooklyn, New York, USA.

Dtsch Med Wochenschr 2018 Jul 4;113(13):937-944. Epub 2018 Jul 4.

Inflammatory bowel diseases, including Crohn's disease and ulcerative colitis, often occur early in life. Therefore, they affect our patient's individual path of life, their ability to work and the quality of life tremendously, which calls for close and comprehensive medical care. This article features 5 cardinal signs and their diagnostics. Read More

Intern Emerg Med 2018 Sep 12;13(6):881-887. Epub 2018 Jun 12.

Department of Internal Medicine, HCA GME Consortium's Internal Medicine Program, University of Central Florida College of Medicine, Gainesville, FL, USA.

Toxic megacolon (TM) is a potentially fatal condition characterized by non-obstructive colonic dilatation and systemic toxicity. It is most commonly caused by inflammatory bowel disease (IBD). Limited data for TM are available demonstrating incidence, in-hospital outcomes and predictors of mortality. Read More

Curr Med Res Opin 2019 Mar 5;35(3):473-478. Epub 2018 Jul 5.

e Department of Hematology & Oncology , St. Luke's Hospital of Kansas City/University of Missouri , Kansas City , MO , USA.

Background: Clostridium difficile infection (CDI) is a significant health burden, now recognized as the leading cause of acquired diarrhea in patients receiving antibiotic therapy. Complications of infection with this pathogen include severe diarrhea, causing electrolyte imbalances, dehydration, hemodynamic instability, toxic megacolon, shock, and death. Hence it is extremely paramount to stay updated on management options for this infection, especially in cancer patients. Read More

Clin Med (Lond) 2018 Jun;18(3):237-241

St Mary's Hospital Campus, Imperial College London, London, UK.

Antibiotic-associated diarrhoea is among the most common adverse events related to antibiotic use. Most cases are mild, but infection causes a spectrum of disease, ranging from occasional diarrhoea to colitis, toxic megacolon, and potentially death. Recent developments in our understanding of the biology of the gut microbiota have provided new insights into the pathogenesis of these conditions, and have revealed a role for manipulation of the gut microbiota as a novel therapeutic approach. Read More

Int J Surg Case Rep 2018 7;48:34-37. Epub 2018 May 7.

Department of Biomedical Sciences and Human Oncology, Unit of Endocrine, Digestive and Emergency Surgery, University Medical School "A. Moro'', Bari, Italy.

Introduction: Congenital diaphragmatic disease is a quite common condition that usually occurs in the neonatal period, and the diagnosis of congenital diaphragmatic disease in adulthood is rare.

Case Presentation: A 64-years-old Caucasian woman was admitted in emergency at our Department, due to a bowel obstruction and dyspnea. A CT-scan showed a diaphragmatic herniation in the left area, with malposition of dilated transverse and descending colon in the chest. Read More

ChemMedChem 2018 Jul 14;13(14):1414-1420. Epub 2018 Jun 14.

Department of Chemistry, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA.

Clostridium difficile infection (CDI) symptoms range from diarrhea to severe toxic megacolon and even death. Due to its rapid acquisition of resistance, C. difficile is listed as an urgent antibiotic-resistant threat, and has surpassed methicillin-resistant Staphylococcus aureus (MRSA) as the most common hospital-acquired infection in the USA. Read More

Front Microbiol 2018 10;9:646. Epub 2018 Apr 10.

Extracorporeal Immunomodulation Unit, Fraunhofer Institute for Cell Therapy and Immunology, Rostock, Germany.

is the most frequent cause of nosocomial antibiotic-associated diarrhea. The incidence of infection (CDI) has been rising worldwide with subsequent increases in morbidity, mortality, and health care costs. Asymptomatic colonization with is common and a high prevalence has been found in specific cohorts, e. Read More

Am J Health Syst Pharm 2018 May;75(9):e189-e193

Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany

Purpose: A case of detectable systemic vancomycin levels after oral vancomycin administration but not after intracolonic administration in a patient with colonic discontinuity and severe infection (CDI) is reported.

Summary: A 63-year-old woman who had recently undergone pancreas-kidney transplantation developed severe CDI after 13 days of meropenem therapy for presumed urosepsis. Meropenem was stopped immediately, and treatment with oral vancomycin (250 mg every 6 hours) was started. Read More

Inflamm Bowel Dis 2018 Jun;24(7):1510-1519

Interventional Inflammatory Bowel Disease (i-IBD) Unit, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Background And Aims: Pouch sinus is a serious complication in patients undergoing ileal pouch-anal anastomosis. The aim of this study was to verify the efficacy and safety of endoscopic needle knife sinusotomy (NKSi) in the management of pouch sinus.

Methods: All consecutive patients with a pouch sinus treated with NKSi from 2008 to 2016 were identified. Read More

Int J Infect Dis 2018 May 2;70:104-106. Epub 2018 Mar 2.

Division of Infection, Barts Health NHS Trust, London, United Kingdom.

We present a rare case of Shigella flexneri bacteraemia and toxic megacolon, and discuss the challenges of conventional laboratory techniques versus molecular PCR platforms in differentiating between Shigella species and Escherichia coli. Read More

Crit Care Nurs Clin North Am 2018 Mar 29;30(1):109-121. Epub 2017 Nov 29.

College of Health Sciences, School of Nursing, Walden University, 100 Washington Avenue South, Suite 900, Minneapolis, MN 55401, USA.

Gastrointestinal (GI) motility problems are common complications in critical care patients. GI problems contribute to an increased risk of morbidity and mortality. Toxic megacolon (TM) is a type of acquired megacolon categorized as a medical emergency and includes severe inflammation affecting all layers of the colon wall. Read More

Front Microbiol 2017 17;8:2635. Epub 2018 Jan 17.

Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

is a Gram-positive, spore-forming anaerobic human gastrointestinal pathogen. infection (CDI) is a major health concern worldwide, with symptoms ranging from diarrhea to pseudomembranous colitis, toxic megacolon, sepsis, and death. CDI onset and progression are mostly caused by intestinal dysbiosis and exposure to spores. Read More

BMJ Case Rep 2018 Jan 11;2018. Epub 2018 Jan 11.

Department of Intensive Care Unit, Gelderse Vallei Hospital, Ede, The Netherlands.

BMC Genomics 2018 01 2;19(1). Epub 2018 Jan 2.

Department of Genomic and Applied Microbiology & Göttingen Genomics Laboratory, Institute of Microbiology and Genetics, Georg-August-University, Göttingen, Germany.

Background: Clostridioides difficile infections (CDI) have emerged over the past decade causing symptoms that range from mild, antibiotic-associated diarrhea (AAD) to life-threatening toxic megacolon. In this study, we describe a multiple and isochronal (mixed) CDI caused by the isolates DSM 27638, DSM 27639 and DSM 27640 that already initially showed different morphotypes on solid media.

Results: The three isolates belonging to the ribotypes (RT) 012 (DSM 27639) and 027 (DSM 27638 and DSM 27640) were phenotypically characterized and high quality closed genome sequences were generated. Read More

Clin Med Insights Gastroenterol 2017 13;10:1179552217746692. Epub 2017 Dec 13.

Department of Surgery, Vanderbilt University School of Medicine, Nashville, TN, USA.

Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). Emergency colectomies are performed for fulminant colitis (ie, toxic megacolon, profuse bleeding, perforation, or sepsis). The RPC and IPAA involve manipulation of the proximal ileum, which may influence the essential physiological function of gut-associated lymphoid tissues. Read More

Eur J Pediatr 2018 Mar 22;177(3):403-408. Epub 2017 Dec 22.

Institute of Medical Microbiology and Hygiene, National Consultant Laboratory for Clostridium difficile, University of Saarland Medical Centre, Homburg, Germany.

In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. Read More

Z Gastroenterol 2017 Dec 6;55(12):1499-1508. Epub 2017 Dec 6.

Klinik und Poliklinik für Innere Medizin A, Universitätsklinikum Greifswald.

In patients with ileus with dilated intestine in imaging studies, endoscopic decompression appears a feasible option. However, its use is often uncritical and without scientific evidence. Before considering endoscopic intervention, CT-imaging should differentiate between mechanical obstruction and paralytic ileus/intestinal pseudo-obstruction. Read More

Zentralbl Chir 2018 Jun 30;143(3):241-249. Epub 2017 Nov 30.

Chirurgische Klinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland.

Clostridium difficile infections (CDI) are common causes of diarrhoea in hospitalised medical and surgical patients. Clinical presentation ranges from mild diarrhoea to pseudomembraneous enterocolitis of the colon and sometimes the small intestines, with development of a toxic megacolon. Recurrent infections are common. Read More

Semin Pediatr Surg 2017 Dec 5;26(6):367-372. Epub 2017 Oct 5.

Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Division of Pediatric Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania. Electronic address:

The incidence of pediatric-onset ulcerative colitis (UC) is rising. Children often present with a more severe disease phenotype as compared to adults with over a third requiring hospitalization for the management of acute severe ulcerative colitis (ASUC). Further, in pediatric patients presenting with inflammatory bowel disease (IBD) limited to the colon, a definitive diagnosis of UC vs. Read More

BMJ Case Rep 2017 Oct 9;2017. Epub 2017 Oct 9.

The Royal Stoke University Hospital, Stoke-on-Trent, UK.

Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is a rare clinical entity in which there is massive non-toxic colonic dilatation in the absence of a mechanically obstructing lesion. It is an important yet poorly recognised cause of surgical morbidity and mortality occurring typically in elderly patients with multiple comorbidities. ACPO can often be reversed conservatively with colonoscopic or nasogastric decompression. Read More

J Trauma Acute Care Surg 2017 Oct 4. Epub 2017 Oct 4.

aAcademic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, B152TH bNIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, B152TH cUniversity of Birmingham, Birmingham, UK.

There has been recent evidence from a large multi-center study sponsored by the Eastern Association for the Surgery of Trauma that colon-sparing surgery reduces mortality for patients with severe Clostridium difficile associated disease (CDAD) when compared to total colectomy. Amoebic colitis shares many pathologic and clinical features to CDAD, such as worsening diarrhoea, patchy colonic ulceration and necrosis, toxic megacolon, pseudomembranous colitis, perforation, and death. However, published research regarding amoebic colitis is sparse. Read More

BMJ Case Rep 2017 Sep 26;2017. Epub 2017 Sep 26.

Department of Interventional Radiology, Auckland District Health Board, Auckland, New Zealand.

A 35-year-old nulliparous woman underwent uterine artery embolisation (UAE) for heavy menstrual bleeding and anaemia due to fibroids, refractive to medical and surgical treatment.Bilateral UAE was performed after cephazolin prophylaxis and analgesia. Postoperatively, pain and abdominal bloating were prominent. Read More

Inflamm Bowel Dis 2017 10;23(10):1790-1795

Division of Gastroenterology, Mount Sinai Hospital, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Introduction: Current clinical practice guidelines suggest that patients with ulcerative colitis (UC) hospitalized because of a disease flare should be offered a normal diet, unless such a diet is not tolerated. Studies of hospitalized patients have demonstrated iatrogenic malnutrition from unjustified or inappropriate nil per os (NPO) or clear liquid diet (CLD) orders. In this study, we aim to characterize the burden of this problem in hospitalized patients with UC. Read More

Front Immunol 2017 2;8:901. Epub 2017 Aug 2.

Laboratory of Control and Systems Biology, National Tsing Hua University, Hsinchu, Taiwan.

is the leading cause of nosocomial antibiotic-associated diarrhea and the major etiologic agent of pseudomembranous colitis. In severe cases, infection (CDI) can cause toxic megacolon, intestinal perforation, and death. The intestinal epithelium is the first tissue encountered in the adhesion and colonization of , and serves as a physical defense barrier against infection. Read More

Gut Pathog 2017 14;9:45. Epub 2017 Aug 14.

Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.

Background: is the causative agent of . infection (CDI) that could be manifested by diarrhea, pseudomembranous colitis or life-threatening toxic megacolon. The spread of certain strains represents a significant economic burden for health-care. Read More

MBio 2017 08 8;8(4). Epub 2017 Aug 8.

Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

is a spore-forming anaerobic bacterium that causes colitis in patients with disrupted colonic microbiota. While some individuals are asymptomatic carriers, symptomatic disease ranges from mild diarrhea to potentially lethal toxic megacolon. The wide disease spectrum has been attributed to the infected host's age, underlying diseases, immune status, and microbiome composition. Read More

Int J Infect Dis 2018 Feb 20;67:86-91. Epub 2017 Jul 20.

Department of Microbiology, Chinese People's Liberation Army General Hospital, Beijing, China. Electronic address:

Clostridium difficile is a Gram-positive, spore-forming obligate anaerobe responsible for antibiotic-associated diarrhoea. Its virulence is associated with the production of endotoxins A and B and endospores, which can cause symptoms, such as diarrhoea, toxic megacolon, and pseudomembranous colitis. Given the increasing elderly population and the well-recognized problem of over-prescribing of broad-spectrum antibiotics, it is critical to have an understanding of molecular epidemiology and antimicrobial susceptibility in China. Read More

Curr Gastroenterol Rep 2017 Aug;19(8):34

Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Purpose Of The Review: Review tests available for detection of Clostridium difficile (C. Diff) induced disease, including when such tests should be done in children and how they should be interpreted.

Recent Findings: Multiple tests are available for detecting disease due to C. Read More

Rev Gastroenterol Mex 2018 Jan - Mar;83(1):41-50. Epub 2017 Jul 3.

Departamento de Microbiología y Parasitología, Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Naucalpan de Juárez, Estado de México, México.

Clostridium difficile is a Gram-positive bacillus that has become one of the main hospital-acquired human gastrointestinal infections in recent years. Its incidence is on the rise, involving more virulent strains, affecting new and previously uncontemplated groups of patients, and producing changes in clinical presentation and treatment response that influence disease outcome. Early diagnosis and disease stratification based on the severity of C. Read More

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2017 Jun;29(6):564-567

Department of Critical Care Medicine, General Hospital of Tianjin Medical University, Tianjin 300052, China. Corresponding author: Liu Bin, Email:

Objective: Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak. Read More

Neurogastroenterol Motil 2017 Nov 5;29(11). Epub 2017 Jun 5.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

Background: Colonic pseudo-obstruction (CPO) is characterized by colonic distention in the absence of mechanical obstruction or toxic megacolon. Concomitant secretory diarrhea (SD) with hypokalemia (SD-CPO) due to gastrointestinal (GI) loss requires further characterization.

Aim: To perform a systematic review of SD-CPO, report a case study, and compare SD-CPO with classical CPO (C-CPO). Read More

BMJ Case Rep 2017 May 22;2017. Epub 2017 May 22.

Gastroenterology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.

Extraintestinal is rare. A 74-year-old man with a history of ulcerative colitis presented after a fall. Trauma work-up showed liver cirrhosis. Read More