Recurrent ulcerative colitis and/or diversion colitis occur commonly in the rectal remnant after colectomy for ulcerative colitis. We report a case in which such a patient's symptoms of rectal discharge were initially thought to be the result of one or both of these diagnoses, on both clinical and histologic grounds. However, examination of the discharge revealed Clostridium difficile infection. Treatment with metronidazole suppositories improved his symptoms and avoided further inappropriate intervention.
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