Background:
Collagenous colitis (CC) is microscopic colitis characterized by watery
diarrhea without bloody stools. The main treatment for CC is
discontinuing the causative drugs and smoking cessation. Very few
patients are refractory to drug treatment and require surgical
management.
Case presentation: A 58-year-old female presented to the
hospital with the chief complaint of lower abdominal pain and was
diagnosed with colonic perforation by computed tomography. The patient
then was transferred to our hospital for surgery. Emergency surgery
revealed perforation in the descending colon, and partial colon
resection and ileostomy were performed. Macroscopic examination revealed
a longitudinal ulcer and no diverticulum. Histopathological examination
revealed a collagenous colitis. The patient had a history of smoking,
and was prescribed lansoprazole. She subsequently smoking, and
lansoprazole was changed to famotidine. The patient had an uneventful
post-procedural course without any complications and was discharged on
day 10. Ileostomy closure was performed 3 months after discharge.