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ABSTRACTBackground: Clostridium difficileinfection of the colon is a common and well-described clinical entity. Clostridium difficileenteritis of the small bowel is believed to be less common and has been described sparsely in the literature.Methods: Case report and literature review.Results: We describe a patient who had undergone total proctocolectomy with ileal pouch–anal anastomosis who was treated with broad-spectrum antibiotics and contracted C. difficilerefractory to metronidazole. The enteritis resolved quickly after initiation of combined oral vancomycin and metronidazole. A literature review found that eight of the fifteen previously reported cases of C. difficile-associated small-bowel enteritis resulted in death.Conclusions: It is important for physicians who treat acolonic patients to be aware of C. difficileenteritis of the small bowel so that it can be suspected, diagnosed, and treated. [ABSTRACT FROM AUTHOR]