TY - JOUR T1 - Deadly combination: <em>Clostridium septicum</em> and colorectal malignancy JF - BMJ Case Reports DO - 10.1136/bcr-2017-222759 VL - 2017 SP - bcr-2017-222759 AU - Carolyn Cullinane AU - Helen Earley AU - Shona Tormey Y1 - 2017/12/02 UR - http://casereports.bmj.com/content/2017/bcr-2017-222759.abstract N2 - 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. ER -