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Toxic megacolon from C difficile — RCPSC EM MCQ

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HardGI/Abdominal emergenciesToxic megacolon from C difficileRCPSC EM

CTAS 1. A 69-year-old recently treated with clindamycin has profuse diarrhoea, fever, and abdominal distension. BP is 88/54 mmHg, WBC 32, lactate 4.1, and abdominal x-ray shows transverse colon diameter 7 cm. She is confused. What is the most likely diagnosis?

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Correct answer: D — Toxic megacolon from C difficile colitis

Severe C difficile colitis with systemic toxicity and colonic dilatation is toxic megacolon, requiring urgent medical and surgical management.

Reference: AMMI Canada C difficile guidance; IDSA/SHEA C difficile guideline