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World J Emerg Surg 2022 02 13;17(1):11. Epub 2022 Feb 13.

Office of Research Administration, Jersey Shore University Medical Center, Neptune, NJ, USA.

Background: The Total Abdominal Colectomy (TAC) is the recommended procedure for Fulminant Clostridium Difficile Colitis (FCDC), however, occasionally, FCDC is also treated with partial colectomies. The purpose of the study was to identify the outcomes of partial colectomy in FCDC cases.

Method: The National Surgical Quality Improvement Program database was accessed and eligible patients from 2012 through 2016 were reviewed. Read More

Clin J Gastroenterol 2022 Feb 22;15(1):123-127. Epub 2021 Oct 22.

Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

The majority of cases of Shiga toxin-producing Escherichia coli are self-limited; however, the infection can occasionally be complicated by more severe phenomena, such as thrombotic microangiopathy, with resultant end-organ damage to the kidneys, colon, nervous system, and various other tissues. Shiga toxin-induced hemolytic uremic syndrome (ST-HUS)-the constellation of thrombocytopenia, hemolysis, and renal failure resulting from thrombotic microangiopathy in a subset of infections producing the Shiga toxin-is classically observed in the pediatric population. Nevertheless, the diagnosis should be considered in adults with this presentation, and especially in those with colonic findings suggestive of ischemia. Read More

Exp Ther Med 2021 Oct 3;22(4):1112. Epub 2021 Aug 3.

Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.

(CD) is an anaerobic, gram-positive bacterium that can produce a spectrum of gastrointestinal diseases ranging from pseudomembranous colitis to diarrhea to toxic megacolon. The infection is even more difficult to manage as CD produces high-end spores, suggesting that this may be the cause of the dangerous recurrent disease as well as dissemination among healthy members in the community. Spores can be hosted in the digestive tract of both symptomatic and asymptomatic patients. Read More

Am J Infect Control 2022 01 23;50(1):72-76. Epub 2021 Aug 23.

Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

Background: To identify the incidence, associated factors, and impact of hospital-acquired Clostridium difficile infection (CDI) among patients who have undergone orthopedic surgery.

Methods: We retrospectively reviewed the charts of all adults patients who underwent orthopedic surgery from January 2016 through December 2017 at a tertiary hospital.

Results: Of 7,363 patients who underwent orthopedic surgical procedures, 52 (0. Read More

Colorectal Dis 2021 12 14;23(12):3213-3219. Epub 2021 Aug 14.

Colorectal Surgical Unit, Department of Surgery, The Royal Melbourne Hospital and University of Melbourne, Melbourne, Victoria, Australia.

Aim: A diverting ileostomy is typically performed to divert intestinal contents in high-risk colorectal anastomoses. Ileostomy closure is associated with high rates of postoperative Clostridium difficile infection (CDI). Risk factors for the development of CDI are unclear; however, a correlation has been observed with delayed closure. Read More

Transpl Infect Dis 2021 Aug 23;23(4):e13694. Epub 2021 Jul 23.

Department of Infectious Diseases, Singapore General Hospital, Singapore.

Pseudomembranous colitis (PMC) is classically associated with Clostridium difficile infection. We report a rare case of cytomegalovirus (CMV)-associated PMC in a 52-year-old female patient who had undergone kidney transplantation more than 20 years ago and was on low dose prednisolone and ciclosporin. She presented with an acute history of fever, lethargy, vomiting and diarrhoea on admission. Read More

Am J Ther 2021 Jul-Aug 01;28(4):e492-e493

Division of Gastroenterology, Vidant Medical Center, East Carolina University, Greenville, NC.

J Trauma Acute Care Surg 2021 08;91(2):422-426

From the Department of Surgery (M.S.), Macerata Hospital, Macerata; General, Emergency and Trauma Surgery Department (L.A.), Bufalini Hospital, Cesena, Italy; Trauma and Acute Care Surgery (W.A.B.), Scripps Memorial Hospital, La Jolla, California; General, Emergency and Trauma Surgery Department (F.C.), Pisa University Hospital, Pisa, Italy; Department of General and Metabolic Surgery (B.D.S.), Poissy and Saint Germain en Laye Hospitals, Poissy, France; Abdominal Center (A.L., M.T.), Helsinki University Hospital Meilahti, Finland; Division of General Surgery (Y.K.), Rambam Health Care Campus, Haifa, Israel; Ernest E. Moore Shock Trauma Center at Denver Health (E.E.M.), Denver, Colorado; and Department of Emergency Surgery (F.C.), Parma Maggiore Hospital, Parma, Italy.

Abstract: In the last three decades, the dramatic worldwide increase in incidence and severity of Clostridioides difficile infection (CDI) (formerly Clostridium difficile infection) has made CDI a global public health challenge. Surgery is a known risk factor for development of CDI yet surgery is also a treatment option in severe cases of CDI. The World Society of Emergency Surgery guidelines for management of CDI in surgical patients were published in 2015. Read More

Dig Liver Dis 2021 Aug 10;53(8):950-957. Epub 2021 Mar 10.

Institute of Pathology, ASST Spedali Civili, Brescia, Italy.

Pathologists are often called upon to diagnose colitides that differ from the two main forms of inflammatory bowel disease (IBD). These non-IBD colitides include infectious colitis, microscopic colitis, ischemic colitis, eosinophilic colitis, autoimmune enterocolitis, segmental colitis associated with diverticulosis, drug-induced colitis, radiation colitis and diversion colitis. The diagnosis of these different disease entities relies on the histopathological examination of endoscopic biopsies of the gastrointestinal tract. Read More

ANZ J Surg 2021 10 24;91(10):2219-2221. Epub 2021 Feb 24.

Department of Surgery, Western Health, Melbourne, Victoria, Australia.

Eur Rev Med Pharmacol Sci 2021 01;25(1):390-396

Clinic of Gastroenterology, Tsaritsa Yoanna University Hospital, Medical University of Sofia, Sofia, Bulgaria.

Objective: For safe implementation and broader application of fecal microbiota transplantation (FMT), quality controlled stool banking is a must. Establishing a stool bank is a complex, time-consuming, and expensive process, making it a real challenge in an Eastern European country. We aimed to establish the first stool bank in Eastern Europe - in Bulgaria. Read More

Dig Dis Sci 2021 12 12;66(12):4441-4447. Epub 2021 Jan 12.

Division of Gastrointestinal and Oncologic Surgery, Northwestern Medicine, Arkes Family Pavilion, 676 North Saint Clair Street, Suite 650, Chicago, IL, 60611, USA.

Background: Patients with ulcerative colitis (UC) are at increased risk for infections such as Clostridium difficile and cytomegalovirus (CMV) colitis due to chronic immunosuppression. These patients often undergo multiple surgeries putting them at risk for recurrence of the infection. However, rates of recurrence in this setting and outcomes are not well understood. Read More

Am Surg 2020 Oct;86(10):1269-1276

VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Diverting loop ileostomy (DLI) with colonic lavage has been proposed as an alternative to total abdominal colectomy (TAC) for fulminant infection (CDI). Controversy exists regarding the mortality benefit and outcomes of this surgical approach. We conducted a MEDLINE database search for articles between 1999 and 2019 pertaining to DLI for the surgical treatment of CDI. Read More

Dis Colon Rectum 2020 09;63(9):1317-1326

Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, New York.

Background: Emergency surgery is often required for fulminant Clostridium difficile colitis. Total abdominal colectomy has been the treatment of choice despite high morbidity and mortality.

Objective: The aim of this meta-analysis was to evaluate postoperative mortality and morbidity after total abdominal colectomy and loop ileostomy with colonic lavage in patients with fulminant C difficile colitis. Read More

Pancreatology 2020 Oct 22;20(7):1323-1331. Epub 2020 Aug 22.

Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.

Background: Acid suppressing drugs (ASD) are generally used in acute pancreatitis (AP); however, large cohorts are not available to understand their efficiency and safety. Therefore, our aims were to evaluate the association between the administration of ASDs, the outcome of AP, the frequency of gastrointestinal (GI) bleeding and GI infection in patients with AP.

Methods: We initiated an international survey and performed retrospective data analysis on AP patients hospitalized between January 2013 and December 2018. Read More

Clin Gastroenterol Hepatol 2022 01 6;20(1):A17. Epub 2020 Sep 6.

Division of Colon and Rectal Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.

ANZ J Surg 2020 09 3;90(9):1769-1770. Epub 2020 Jul 3.

Department of Colorectal Surgery, Box Hill Hospital, Melbourne, Victoria, Australia.

South Med J 2020 Jul;113(7):345-349

From the Division of Trauma & Surgical Critical Care and the Department of Research Administration, Jersey Shore University Medical Center, Neptune, New Jersey.

Objective: The purpose of the study was to evaluate whether early colectomy in patients who have toxic megacolon due to colitis reduces mortality.

Methods: The study was performed using the American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2016. All patients 18 to 89 years of age who underwent colectomy for toxic megacolon resulting from colitis were included in the study. Read More

Trials 2020 Jun 29;21(1):590. Epub 2020 Jun 29.

Harvard Medical School, Boston, MA, USA.

Background: Critically ill infants with congenital heart disease (CHD) are often prescribed stress ulcer prophylaxis (SUP) to prevent upper gastrointestinal bleeding, despite the low incidence of stress ulcers and limited data on the safety and efficacy of SUP in infants. Recently, SUP has been associated with an increased incidence of hospital-acquired infections, community-acquired pneumonia, and necrotizing enterocolitis. The objective of this pilot study is to investigate the feasibility of performing a randomized controlled trial to assess the safety and efficacy of withholding SUP in infants with congenital heart disease admitted to the cardiac intensive care unit. Read More

Langenbecks Arch Surg 2020 Sep 18;405(6):715-723. Epub 2020 Jun 18.

Department of Colorectal Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Tlalpan, 14080, Mexico City, Mexico.

Background: Clostridium difficile is an increasingly common source of in-patient morbidity and mortality. We aim to assess the effects of diverting loop ileostomy (DLI) versus total abdominal colectomy (TAC) for Clostridium difficile colitis (CDC), in terms of mortality and morbidity.

Methods: Systematic literature search was performed using PubMed, Embase, Cochrane, and Web of Science databases for randomized and non-randomized studies comparing DLI and TAC for fulminant CDC. Read More

Chirurgia (Bucur) 2020 Mar-Apr;115(2):227-235

The emergency surgery for colorectal cancer is associated with high rates of morbidity and mortality due to factors related to the characteristics of the patients but also the therapeutic attitude. This study aims to identify the surgical interventions associated with the postoperative complications, with the main causes of morbidity, with the reinterventions and with the postoperative deaths. We included in this retrospective study 431 patients hospitalized and operated in an emergency for complicated colorectal malignant tumors in the Surgery II Clinic of the Clinical Emergency County Hospital "Sf. Read More

Clin Transl Gastroenterol 2020 03;11(3):e00134

Department of Medicine B, Gastroenterology and Hepatology, University Hospital Münster, Münster, Germany.

Objectives: In patients with inflammatory bowel disease (IBD), a treat-to-target treatment strategy requires tight monitoring of disease activity. Noninvasive biomarkers may help to monitor the intestinal disease activity. We demonstrated recently that peripheral microRNA (miR)-320a expression in mice follows the course of experimental colitis. Read More

Surg J (N Y) 2020 Jan 3;6(1):e37-e41. Epub 2020 Mar 3.

Department of Internal Medicine and Medical Gastroenterology, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India.

Hepatic portal venous gas (HPVG), a rare radiological finding, is historically considered an ominous sign with 100% mortality rates. The dictum that HPVG warrants surgical intervention is challenged in the recent literature. This is because of the identification of various causes of HVPG other than bowel gangrene. Read More

Inflamm Bowel Dis 2020 11;26(12):1901-1908

Liver Transplant Unit, Heidelberg, Victoria, Australia.

Background: The impact of inflammatory bowel disease (IBD) activity on long-term outcomes after liver transplantation (LT) for primary sclerosing cholangitis (PSC) is unknown. We examined the impact of post-LT IBD activity on clinically significant outcomes.

Methods: One hundred twelve patients undergoing LT for PSC from 2 centers were studied for a median of 7 years. Read More

Aliment Pharmacol Ther 2020 01;51(1):208-209

Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, TX, USA.

J Infect Chemother 2020 Mar 9;26(3):305-308. Epub 2019 Dec 9.

Department of Bacteriology II, National Institute of Infectious Diseases, Japan. Electronic address:

A 74-year-old male was referred to our critical care department for refractory severe watery diarrhea with advanced leukocytosis (over 70,000/μl) after multiple administrations of eradication therapy against Helicobacter pylori (HP). He was diagnosed as having fulminant colitis due to Clostridioides difficile after antimicrobial eradication therapy. He was given intravenous metronidazole and oral vancomycin. Read More

J Gastrointest Surg 2020 02 25;24(2):484-491. Epub 2019 Nov 25.

Department of Surgery, University of California, Davis, Medical Center, 2335 Stockton Blvd., Sacramento, CA, 95817, USA.

Clostridium difficile infection remains a common nosocomial illness with a significant impact on health care delivery. As molecular phenotyping of this organism has changed our understanding of its transmission and virulence, so too have diagnostic methods and treatment strategies evolved in recent years. The burden of this infection falls predominantly on elderly patients with comorbidities who have recently received antibiotics. Read More

Inflamm Bowel Dis 2020 07;26(8):1212-1221

Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati, OH, USA.

Background: Clostridioides difficile infection and colonization are common in pediatric Crohn's disease (CD). Our aims were to test the relationship between C. difficile positivity and bowel resection surgery and to characterize microbial shifts associated with C. Read More

JAMA Surg 2020 02;155(2):174-175

Cardiovascular Outcomes Research Laboratories (CORELAB), Department of Surgery, University of California, Los Angeles.

JAMA Surg 2020 02;155(2):174

Jyoban Hospital of Tokiwa Foundation, Iwaki-City, Fukushima, Japan.