Department of Gastroenterology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 6510260, Chile.
World J Gastroenterol. 2013 Jan 14;19(2):316-8. doi: 10.3748/wjg.v19.i2.316.
The most frequent cause of pseudomembranous colitis is Clostridium difficile (C. difficile) infection. This type of colitis is characterized by an endoscopic pattern of numerous small, yellowish or whitish plaques diffusely distributed, which typically compromises the rectum extending to proximal colon. Occasionally, the pseudomembranes compromise only the transverse or right colon, but their exclusive localization over polyps has not been reported. In this case report we have described a patient with symptoms compatible with C. difficile infection and positive for C. difficile toxigenic culture. Colonoscopy examination showed two small polyps with a whitish surface, and histopathological analysis confirmed them to be pseudomembranes over tubular adenomas. The rest of the colonic mucosa was normal and no other cause was demonstrated. We suggest that this particular distribution might be due to a higher affinity for dysplastic cells such as adenomatous polyps of colon by C. difficile and/or its toxins.
伪膜性结肠炎最常见的病因是艰难梭菌（C. difficile）感染。这种类型的结肠炎的内镜表现为广泛分布的大量小的、黄色或白色斑块，通常累及直肠并延伸至近端结肠。偶尔，假膜仅累及横结肠或右半结肠，但尚未报道其仅局限于息肉上。在本病例报告中，我们描述了一位符合艰难梭菌感染症状且艰难梭菌产毒培养阳性的患者。结肠镜检查显示两个带有白色表面的小息肉，组织病理学分析证实它们是管状腺瘤上的伪膜。结肠其余黏膜正常，未发现其他病因。我们推测，这种特殊的分布可能是由于艰难梭菌及其毒素对结肠腺瘤等异型细胞具有更高的亲和力。
