Acquiring Tetanus After Hemorrhoid Banding and Other Gastrointestinal Procedures

Abstract

Tetanus after hemorrhoidal banding is an extremely rare but serious complication of the procedure. We describe the second reported case of this complication and review the literature concerning tetanus after different gastrointestinal procedures. Although a rare complication, practicing physicians need to be aware of the clinical presentation of this deadly disease when encountered in at-risk patient populations. Such cases also reemphasize the importance of primary tetanus immunization and follow-up boosters for all vulnerable patients.

Retrospective evaluation of 155 adult equids and 21 foals with tetanus in Western, Northern, and Central Europe (2000–2014). Part 1: Description of history and clinical evolution

“…One result of particular note was the observation that castration and hoof abscesses were the most common predisposing events for the development of tetanus in this group of horses; this highlights the importance of undertaking appropriate vaccination prior to performing elective surgical procedures and TAT or booster vaccination in case of hoof abscesses. Clostridium tetani is also a common inhabitant of the gastrointestinal tract of horses and, similar to the situation in people, intestinal lesions are likely to be a potential entry site for the bacterium in horses . Unfortunately in the present study insufficient data were gathered on deworming protocols and parasitic lesions on postmortem examinations to study a possible relation between parasitic infestations and the development of tetanus.…”

Risk of Clostridium tetani infection in an elderly patient following hemorrhoid ligation

“…We found 19 case reports of tetanus following gastrointestinal procedures. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Table 1 outlines the findings and case summaries. In a study of 2422 patients with tetanus, 21.9% of patients did not have significant wound invasion, and it has been speculated that C. tetani may also invade the body through small abrasions.…”

Postoperative tetanus after laparoscopic obturator hernia repair for strangulated ileus: report of a case

“…We found a total of only 16 case reports of tetanus after gastrointestinal surgical procedures. The procedures included open cholecystectomy (four cases) [4][5][6] cholecystectomy with exploration of the bile duct (two cases) [7], resection for a gangrenous small intestine (two cases) [8,9], rubber band ligation of hemorrhoids (two cases) [10,11], cryosurgery for internal hemorrhoids [12], drainage of an anorectal abscess [13], sigmoidoscopic polypectomy [14], gastrectomy and transverse colectomy [15], pyloroplasty and oversewing of a bleeding duodenal ulcer [16], and exploratory laparotomy for carcinoma in the omentum and liver [5]. These cases are summarized in Table 1.…”