Article Text

PDF

CASE REPORT
Deadly combination: Clostridium septicum and colorectal malignancy
  1. Carolyn Cullinane1,
  2. Helen Earley1,
  3. Shona Tormey2
  1. 1 General Surgery, University Hospital Limerick, Dooradoyle, Limerick, Ireland
  2. 2 General Surgery, University Hospital Limerick, Limerick, Ireland
  1. Correspondence to Dr Carolyn Cullinane, cc3189{at}hotmail.com

Summary

Gas gangrene is a life-threatening, necrotising soft tissue infection. Colorectal malignancy-associated Clostridiumsepticum is a rare cause of gas gangrene. This case outlines an initial presentation of colonic malignancy as gas gangrene from C.septicum infection.

A 69-year-old man presented with abdominal pain, vomiting and constipation. Abdominal X-ray revealed dilated small bowel loops. Lactate was elevated. A diagnosis of small bowel obstruction was made. Subsequent CT revealed caecal thickening and subcutaneous emphysema overlying the left flank. Clinically, he became haemodynamically unstable. Examination revealed crepitus overlying the left flank in keeping with gas gangrene. The patient required immediate surgical debridement. Tissue specimens cultured C.septicum. Following a complicated postoperative period, he was transferred to the plastic surgery team for further tissue debridement and reconstruction. A colonoscopy was later performed which was suspicious for malignancy. Colorectal multidisciplinary team discussion is awaited.

  • colon cancer
  • general surgery
  • plastic and reconstructive surgery
  • infections

Statistics from Altmetric.com

Footnotes

  • Contributors CC: Author and data collection. HE: Editing. ST: Editing and provision of images.

  • Competing interests None declared.

  • Patient consent Obtained.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.