Spontaneous Intrahepatic Gas Gangrene and Fatal Septic Shock

Abstract

Gas gangrene of the liver is a rare clinical syndrome associated with a high rate of mortality. It is mostly associated with malignancy and immunosuppression. We report on a male patient who presented at the department of emergency medicine with high fever but no localised complaints. CT scan revealed a cavitary lesion filled with air in the liver. Clostridium perfringens was proved to be present in the hepatic lesion and the blood, and clostridium perfringens sepsis with gas gangrene of the liver was diagnosed. Despite early diagnosis and treatment the patient died. The importance of "an aggressive treatment policy" in this kind of life-threatening disease is emphasised.

Spontaneous Pneumobilia: Not So Benign

“…The etiologies are related to either some form of a biliary-enteric fistula or emphysematous cholecystitis [ 2 , 3 ]. The additional finding of air within the portal venous system indicates bowel wall ischemia, gas gangrene, or pyogenic liver abscess [ 4 , 5 ]. There have been sporadic reports of pneumobilia caused by bacterial cholangitis and parasites such as Echinococcus [ 1 , 6 ].…”

Fulminant abdominal gas gangrene in metastatic colon cancer

“…Sudden tissue necrosis and/ or external air during the procedure may be entrapped in the lesion. If the lesion is superimposed with pyogenic infection, (1,3,5). Portal venous gas has been reported as a rare but life-threatening complication of colon cancer.…”

“…If anaerobic infection is the affecting cause, the infected tumor site may present with gas gangrene, which may have a fatal outcome. Diagnosis of gas gangrene of an anaerobic infection is frequently obtained via imaging findings (3,4). We report a case of fulminant gas gangrene in a patient with colon cancer, who presented with air in the portal vein, lymph node and liver metastases resulting in pneumoperitoneum complications.…”

Primary abdominal gas gangrene: a report of two autopsy cases

“…Gas gangrene is an infection caused predominantly by Clostridium perfringens and is most commonly associated with soft tissue infections of the extremities after trauma. [1][2][3][4] This entity is also known as bacterial myonecrosis. 1 Non-traumatic gas gangrene is rare, and most commonly, the site of the primary infection is in the abdominal cavity, involving predominantly the liver, pancreas, or gallbladder.…”

“…It is frequently associated with malignancy, immunosuppression, or severe organic degenerative changes. 3,[5][6][7][8] Herein, we report two autopsy cases of primary hepatic gas gangrene.…”