DOI: https://doi.org/10.22263/2312-4156.2024.5.86
I.А. Rutskaya1,2
Clostridioides difficile colitis: echographic characteristics
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Vitebsk Regional Clinical Infectious Diseases Hospital, Vitebsk, Republic of Belarus
Vestnik VGMU. 2024;23(5):86-93.
Abstract.
The relevance of enterocolitis is increasing everywhere, the etiologic factor of which is Clostridioides difficile (Cl. difficile).
Objectives. To determine ultrasonographic criteria of the severe Cl. difficile infection based on the intestine echographic images of patients.
Material and methods. 90 patients with Cl. difficile colitis (27 men and 63 women) were examined. Clostridioides difficile infection was detected by means of the immunochromatographic test with the determination of microbial toxins in patients’ feces. Ultrasound investigation (US) was performed using convex 3.5-4.0 MHz and linear 9.0-10.0 MHz probes without special preparation of patients for the examination.
Results. According to the ultrasound data in patients with Cl. difficile colitis an increase of the colon wall thickness was determined. Thickening of the colon wall detected in a severe form of pseudomembranous colitis (PMC) was more significant than in its mild and moderate form (Me=9,6 mm and Me=4,3 mm, respectively, p<0.0001). Total colon wall thickening more than 7,2 mm in any colon segment, as well as the combination of wall thickening of more than 7,2 mm with the presence of any severe course of PMC additional signs is established to be the severe course of Cl. difficile colitis predictor. Such additional signs include: the appearance of paracolic free fluid and ascitic fluid in various abdominal regions; increased echogenicity and volume growth of pericolic fat surrounding the inflamed colon; impaired colonic wall stratification; more than 3.0 mm small-bowel wall thickening; dilatation and paralysis of the colon; toxic megacolon.
Conclusions. Intestinal ultrasound in patients having PMC makes it possible to identify the severe form of Cl. difficile infection.
Keywords: ultrasonography, pseudomembranous colitis, Clostridioides difficile, colon.
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Submitted 07.08.2024
Accepted 18.10.2024
Information about authors:
I.А. Rutskaya – ultrasound diagnostics doctor, Vitebsk Regional Clinical Infectious Diseases Hospital,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Irina Аlexandrovna Rutskaya.
