Clostridium difficile Colitis in Patients Undergoing Surgery for Adolescent Idiopathic Scoliosis

PURPOSE OF THE STUDY To identify risk factors associated with developing Clostridium difficile infection (CDI) in adolescent idiopathic scoliosis patients after surgery and to describe the clinical presentation of CDI in these patients. Clostridium difficile colitis is reportedly increasing in hospitalized patients and can have a negative impact on patient outcomes. No data exist on CDI rates and its consequences on patient undergoing surgery for adolescent idiopathic scoliosis. MATERIAL AND METHODS A retrospective database review of patients who underwent elective idiopathic scoliosis surgery between January 2019 to June 2021 was conducted. The population was divided into patients who developed Clostridium difficile colitis and those who did not. RESULTS A total of 128 patients were included in the study. We did not find notable risk factors for the development of CDI. In 2 patients diagnosis of CDI, was made. Length of hospital stays, and readmissions were significantly higher in patients with CDI. CONCLUSIONS CDI is a rare post-surgical complication in patients who undergo surgery for idiopathic scoliosis. Currently, we cannot identify predisposing factors for the development of CDI in adolescent idiopathic scoliosis patients. A high index of suspicion is necessary for timely diagnosis and treatment in patients presenting with abdominal symptoms around post-operative day 5 after surgical treatment for idiopathic scoliosis. Key words: Clostridium difficile infection, adolescent idiopathic scoliosis, abdominal pain, diarrhea.

Intestinal pseudoobstruction

Intestinal pseudoobstruction is an uncommon clinical condition of varied etiologies. Confusion in its characterization and diagnosis often results in delay in diagnosis as well as inappropriate treatment involving repeated surgery. The various aspects and characteristics of intestinal pseudoobstruction are described by representative case reports of three patients treated in our department with a review of the literature. Heightened awareness, understanding of the physiological dynamics and recognition of the spectrum of its clinical presentation and diagnostic modalities should result in more efficacious treatment.