Open Access, Peer-reviewed
pISSN 2288-6575
eISSN 2288-6796
    J Korean Surg Soc. 2009 Aug;77(2):106-112. Korean.
    Published online Aug 04, 2009.
    https://doi.org/10.4174/jkss.2009.77.2.106
    Copyright © 2009 The Korean Surgical Society
    Original Article

    Pseudomembranous Colitis after Gastrointestinal Operation

    Byung Soo Park, M.D., Jae Hun Kim, M.D., Hyung Il Seo, M.D., Hyun Sung Kim, M.D., Dae Hwan Kim, M.D., Hong Jae Cho, M.D., Tae Yong Jeon, M.D., Dong Heon Kim, M.D., Mun Sup Sim, M.D., Suk Kim, M.D.,1 and Hyung Sook Kang, Ph.D.2
      • Department of Surgery, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
      • 1Department of Radiology, Postgraduate School of Medicine, Pusan National University, Busan, Korea.
      • 2College of Sport Sciences, Dong-A University, Busan, Korea.
    • Corresponding author (Email: 111160@pusan.ac.kr )
    Received March 19, 2009; Accepted May 13, 2009.

    Abstract

    Purpose

    The risk factors of pseudomembranous colitis (PMC) are well known. However, there have been no studies of PMC after gastrointestinal operation. The aim of this study was to evaluate the risk factors and to establish the guiding principles for PMC after gastrointestinal operation.

    Methods

    We performed a retrospective study of 39 PMC patients after gastrointestinal operation from January 2004 to December 2008. A control group of one hundred and seventeen matched to a PMC group by date of operation was chosen in a random fashion. Preoperative, operative, and postoperative factors of PMC were evaluated.

    Results

    The incidence of PMC after gastrointestinal operation was 0.63%. On univariate analysis, among preoperative factors, albumin, PT-INR and neutropenia were significant risk factors for PMC. There was no difference in the operative factors. Among postoperative factors, duration of cephalosporin, aminoglycoside, H2 blocker administration were significant risk factors for PMC after gastrointestinal operation. And transfusion, duration of NPO, length of stay in intensive care unit (ICU) and postoperative intraabddominal abscess, pneumonia were also significant risk factors. On multivariate analysis, the independent risk factors for PMC after gastrointestinal operation were duration of aminoglycoside administration, transfusion volume and length of stay in ICU. When period of study was divided by three months, incidence of PMC at a specific period was high. After limiting of prophylactic antibiotics, incidence of PMC fell to 0.36%.

    Conclusion

    To prevent PMC after gastrointestinal operation, we need sustained efforts to establish stricter guidelines about prophylactic antibiotics and transfusion, and to minimize length of stay in ICU.

    Keywords
    Pseudomembranous colitis; Gastrointestinal operation

    Figures

    Fig. 1
    Overall incidence of pseudomembranous colitis. Arrow = prophylactic antibioticslimiting point.

    Tables

    Table 1
    Preoperative characteristics of pseudomembranous colitis group and control group

    Table 2
    Operative characteristics of patients with pseudomembranous colitis and control group

    Table 3
    Postoperative characteristics of patients with pseudomembranous colitis and control group

    Table 4
    Multivariate analysis of risk factors for pseudomembranous colitis after gastrointestinal operation

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    MeSH Terms
    Abscess
    Anti-Bacterial Agents
    Enterocolitis, Pseudomembranous
    Humans
    Incidence
    Intensive Care Units
    Length of Stay
    Multivariate Analysis
    Neutropenia
    Pneumonia
    Retrospective Studies
    Risk Factors
    Metrics
    Share
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