Gas gangrene--a ten-year survey from the Royal Adelaide Hospital

Occult clostridial myonecrosis

Nontraumatic gas gangrene is extremely rare. It usually occurs following ulceration or perforation of an abdominal or pelvic viscus in persons having impaired host immune defenses. A fatal case of nontraumatic Clostridium septicum septicemia and myonecrosis in an elderly diabetic man with a perforated colon carcinoma is presented. The case illustrates the occult manner in which such cases typically present and the fulminant course of this disease. The need for rapid diagnosis and the current recommended treatment of gas gangrene are discussed.

Gas gangrene infections of the small intestine, colon and rectum

Thirty-three cases of gas gangrene infections originating from the small bowel, colon, and rectum are reviewed. The distinction between localized and diffuse, spreading, types of infection is made. The overall mortality rate was 42.4% and mortality was highest for infections following elective bowel resections. Treatment consisted of antibiotics and surgical debridement, with hyperbaric oxygen used as adjunctive therapy for the more serious cases. The importance of early recognition of clostridial infection is stressed as the key to improved survival.