Diverting loop ileostomy/colonic lavage in managing fulminant Clostridioides (formerly Clostridium) difficile colitis in adults

This algorithm is intended for choosing between total abdominal colectomy and diverting loop ileostomy/colonic lavage as the initial surgical treatment for fulminant C. difficile colitis. Surgeons who do not perform the latter procedure can use total abdominal colectomy for all such patients. Limited studies have associated diverting loop ileostomy/colonic lavage with lower mortality, but those studies were not randomized trials.