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Adult necrotising enterocolitis—pig-bel disease: a Pacific disease in London
  1. Justin Conrad Rosen Wormald,
  2. Sanjay Dindyal,
  3. Francesca Mellor,
  4. Nebil Behar
  1. Department of Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Justin Conrad Rosen Wormald, justinwormald{at}


Adult necrotising enterocolitis secondary Clostridium perfringens type C—pig-bel disease—is rarely seen outside of Pacific populations, with the highest incidence being in Papau New Guinea. We present the first reported case of pig-bel disease in a previously well patient without diabetes following food poisoning since 1996. In this case, the enterotoxin-induced disease necessitated emergency laparotomy and bowel resection following the failure of medical treatment and worsening septic shock. We hypothesise that obstruction secondary to a sigmoid diverticular stricture complicated by infection-related oedema led to colonic stasis and rapid progression of disease and bowel loss. Following bowel resection, several parenteral antibiotic agents and prolonged intensive care, this patient survived this severe infective process and was discharged home.

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  • Contributors All authors have contributed equally to the preparation and submission of this case report. JCRW and FM drafted the manuscript. JCRW and SD reviewed and edited the drafts. NB provided expert input and reviewed final draft prior to submission. All authors were directly involved in the care of the patient.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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