Sudden Onset of Lower Abdominal Pain Without Peritonitis or Ileus

  • Stefania Scarlini Unit of Internal Medicine 2, University Hospital Policlinico of Modena, University of Modena and Reggio Emilia, Modena
  • Marco Gandolfo Unit of Internal Medicine 2, University Hospital Policlinico of Modena, University of Modena and Reggio Emilia, Modena
  • Antonello Pietrangelo Unit of Internal Medicine 2, University Hospital Policlinico of Modena, University of Modena and Reggio Emilia, Modena

Keywords

Gas-gangrene, Clostridium septicum, acute abdominal pain.

Abstract

A patient presented with sudden, unexplained lower abdominal pain without peritonism or signs of infection or inflammatory reaction, but with recent bloody stools and a history of radiation therapy, diabetes and immunosuppression. Plain abdominal x-ray showed only air-fluid levels and air distention of the colon, but a later abdominal CT scan revealed extensive gas gangrene of the colon. The patient’s clinical status rapidly worsened. Elective surgical rectosigmoid debridement did not prevent the patient’s death. In conclusion, the diagnosis of ‘spontaneous’ life-threatening gas gangrene requires a high degree of clinical suspicion and allows life-saving surgical intervention.

VIEW THE ENTIRE ARTICLE

References

  • Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJC, et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis 2005;41:1373–1406.
  • Mishra SP, Singh S, Gupta SK. Necrotizing soft tissue infections: surgeon’s prospective. J Inflamm 2013;2013:1–7.
  • Hartel M, Kutup A, Gehl A, Zustin J, Grossterlinden LG, Rueger JM, et al. Foudroyant course of an extensive Clostridium septicum gas gangrene in a diabetic patient with occult carcinoma of the colon. Orthopedics 2013;2013:1–5.
  • Published: 2016-11-28

    Issue: Vol. 3 No. 7 (view)

    Section: Articles

    How to cite:
    1.
    Scarlini S, Gandolfo M, Pietrangelo A. Sudden Onset of Lower Abdominal Pain Without Peritonitis or Ileus. EJCRIM 2016;3 doi:10.12890/2016_000444.