RT Journal Article SR Electronic T1 Deadly combination: Clostridium septicum and colorectal malignancy JF BMJ Case Reports FD BMJ Publishing Group Ltd SP bcr-2017-222759 DO 10.1136/bcr-2017-222759 VO 2017 A1 Carolyn Cullinane A1 Helen Earley A1 Shona Tormey YR 2017 UL http://casereports.bmj.com/content/2017/bcr-2017-222759.abstract AB 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.