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Clostridium difficile ileitis in a patient, after total colectomy. This is a case of a 63-year-old, post total colectomy patient, who presented to the hospital with watery diarrhoea, abdominal cramping and fevers. On admission, the patient was haemodynamically stable and febrile. Clostridium difficile PCR was sent and tested positive. CT of the abdomen revealed diffuse thickening of the distal small bowel to the level of the anastomosis and mesenteric oedema consistent with infectious enteritis. The patient was started on vancomycin orally as well as flagyl intravenously. Because of an ileus, he initially was treated with bowel rest and a NG tube. Surgical consult was obtained early with no intervention. The patient's symptoms progressively resolved over the next 7 days of hospitalisation, and he was discharged home.