Pseudomembranous colitis: how useful is endoscopy? Surg Endosc 1990;4(4):217-9
Date
01/01/1990Pubmed ID
2291163DOI
10.1007/BF00316796Scopus ID
2-s2.0-0025686283 (requires institutional sign-in at Scopus site) 27 CitationsAbstract
Clostridium difficile colitis may be diagnosed either by endoscopy or by laboratory tests. To determine the role of endoscopy, we reviewed 59 cases of confirmed C. difficile colitis. In all patients, the etiology was confirmed by stool tests. Twenty-nine underwent lower gastrointestinal endoscopy. In 16 (55%) there was endoscopic confirmation of pseudomembranes while 4 (14%) had only nonspecific colitis. There was no apparent difference in the rate of detection of pseudomembranes between rigid sigmoidoscopy (57%), flexible sigmoidoscopy (50%), and colonoscopy (50%). Vancomycin and metronidazole were equally effective therapy but treatment with vancomycin cost more than 250 times that for metronidazole. There were no patients in whom the diagnosis was made by endoscopy alone. Endoscopy was costly and insensitive, while noninvasive stool tests were cheap and accurate. We conclude that endoscopy should be relegated to a secondary role in the workup of antibiotic-associated diarrhea.
Author List
Bergstein JM, Kramer A, Wittman DH, Aprahamian C, Quebbeman EJMESH terms used to index this publication - Major topics in bold
ColonoscopyDrug Therapy, Combination
Enterocolitis, Pseudomembranous
Humans
Metronidazole
Sigmoidoscopy
Vancomycin