23rd January 2024

A 69-year-old male is treated for severe Clostridium difficile infection with vancomycin

A 69-year-old male is treated for severe Clostridium difficile infection with vancomycin. However, he does not improve. His observations reveal a heart rate of 124 beats per minute and fever of 38.7 oC. His latest white cell count (WCC) is 16 x 10⁹/L. A computed tomography (CT) scan of the abdomen is requested as he develops severe abdominal pain and distension. It demonstrates diffuse thickening of the colonic wall, colonic dilatation of 8 cm, and a loss of haustration. He is treated with further antibiotics and with nasogastric decompression, but continues to deteriorate over the next 3 days.

Which of the following is the most appropriate definitive management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.