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Case Reports
. 2017 Dec 2:2017:bcr2017222759.
doi: 10.1136/bcr-2017-222759.

Deadly combination: Clostridium septicum and colorectal malignancy

Carolyn Cullinane  1 , Helen Earley  1 , Shona Tormey  2
Affiliations
Case Reports

Deadly combination: Clostridium septicum and colorectal malignancy

Carolyn Cullinane et al. BMJ Case Rep. .

Abstract

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.

Keywords: colon cancer; general surgery; infections; plastic and reconstructive surgery.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT abdomen sagittal plane (arrow pointing to subcutaneous emphysema left flank).
Figure 2
Figure 2
CT abdomen coronal plane (arrows pointing to subcutaneous emphysema overlying left flank and thickened caecum).
Figure 3
Figure 3
Image of left flank predebridement.
Figure 4
Figure 4
Image of left posterior forearm predebridement.
Figure 5
Figure 5
Image of left flank postdebridement.
Figure 6
Figure 6
Image of left posterior forearm postdebridement.
See this image and copyright information in PMC

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