Introduction: Optimal management of toxic megacolon as a consequence of Cl. difficile colitis is still matter of controversy, as well as timing of available therapeutic modalities. In this article we report a case of severe C. difficile colitis associated with toxic megacolon in a pregnant patient with Covid 19, who was successfully treated conservatively. Case Report: A 33-years old pregnant woman contracted SARS-CoV-2 in the 32nd week of pregnancy. She was admitted to regional hospital and treated extensively by wide-spectrum antibiotics. After the delivery she developed severe form of Cl. difficile colitis with toxic megacolon. In spite of severe clinical picture, the patient was treated conservatively, with high initial oral doses of vancomycin, with subsequent tapering. The outcome of the treatment was complete recovery and colonic functions were regained completely. Conclusion: In conclusion, our case shows that in younger patients, who were fit before occurrence of Cl. difficile colitis and toxic megacolon, conservative therapy should be tried as long as possible before turning to colectomy, since chances for cure without surgery are considerable.

Introduction: Digestive tract bleeding is a clinical problem that requires hospitalization. Hemorrhages from the upper parts of the digestive system have an incidence of 150/100000 persons per year and are the reason for 1.5% of all emergency hospitalizations. The most common cause of bleeding is gastroduodenal ulcer and erosion in three quarters of cases. Endoscopic haemostatic and gastric acidity status are the most important in the treatment of patients. Aim: To analyze the causes of bleeding from the upper parts of digestive tract and the justification for the urgent gastroscopy. The study was conducted at the Clinical Center Kragujevac in Kragujevac, Serbia. Methods: The study included patients (200) who reported to the emergency room of the Emergency Medicine Center with the clinical picture of bleeding from the upper parts of the digestive tract. Results: Most patients had ulcerative changes at gastric level (58.6%). The most common symptom was melena present in 152 patients. Endoscopic therapy was administered to 44 patients, with 38 patients (86.4%) resulting in arresting bleeding. Conclusion: Hemorrhages from the upper parts of the digestive tract are most commonly caused by peptic ulcers, more common in older, male patients. The first form of diagnosis and therapy is endoscopy, with an efficacy greater than 70%.