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.