Fatal Clostridium welchii septicemia following cholecystectomy

Turner, Fennell P.

doi:10.1016/0002-9610(64)90070-4

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…Cases of clostridial infections following conventional biliary surgery first appear in the literature in 1960’s (2). Graybeal summarised 3 cases of clostridial sepsis and highlighted a reported total of 24 in 1982 (3).…”

Section: Introductionmentioning

confidence: 99%

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Clostridium perfringens sepsis and liver abscess following laparoscopic cholecystectomy

Qandeel¹,

Abudeeb²,

Hammad³

et al. 2012

Journal of Surgical Case Reports

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Clostridium perfringens sepsis with intravascular haemolysis is a catastrophic process with a reported mortality of between 90 to 100%. We successfully treated a case of severe clostridial infection with a liver abscess following laparoscopic cholecystectomy, the first to our knowledge. A 59-year-old man presented one week after an uneventful laparoscopic cholecystectomy with jaundice, peritonism, sepsis and acute renal failure. He was found to have a haemolytic anaemia, unconjugated hyperbilirubinemia and blood cultures grew Clostridium perfringens. A CT revealed a large gas forming abscess in the gallbladder fossa and right lobe of liver. He was treated with directed antibiotic therapy and underwent emergency laparotomy, drainage of the abscess and peritoneal washout. He required intensive care support, parenteral nutrition and inotropic support for a limited period. CT liver angiogram post op was normal. Continued renal dysfunction necessitated protracted haemofiltration. This resolved and the patient was discharged home at 2 months.

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Section: Introductionmentioning

confidence: 99%

“…Rapid deterioration, haemolysis, septic shock and renal dysfunction are common to all (2-6). We observed a case of severe clostridial infection with a liver abscess following laparoscopic cholecystectomy, the first to our knowledge.…”

Section: Introductionmentioning

confidence: 99%

Clostridium perfringens sepsis and liver abscess following laparoscopic cholecystectomy

Qandeel¹,

Abudeeb²,

Hammad³

et al. 2012

Journal of Surgical Case Reports

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show abstract

“…Our current approach to the patient undergoing elective cholecystectomy for chronic cholecystitis is to (1) withhold antibiotics preoperatively, (2) perform intraoperative Gram's staining, and (3) use antibiotics intraoperatively and postoperatively if Gram-positive rods are present, which indicates colonization with clostridial species.…”

Section: Resultsmentioning

confidence: 99%

“…The present study was performed to determine (1) the incidence of bactibilia in patients who underwent elective cholecystectomy, (2) the accuracy of Gram's stain as a predictor of bactibilia, and (3) the septic complication rate and its relationship to bactibilia and use of antibiotics.…”

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confidence: 99%

Elective Cholecystectomy

Farnell¹,

Heerden²,

Beart³

1981

Arch Surg

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“…Pyrtek & Bartus (1962), realizing the indispensibility of early diagnosis in the management of infection after biliary tract surgery, adopted the policy of culturing the bile at the time of surgery. Turner (1964) stated that Clostridium welchii bacteraemia may follow such a fulminating course that treatment must be started before reports of positive cultures are available. He also advises that stained smears of material from the gall-bladder and common duct be examined for Gram-positive bacilli postoperatively in order to provide a more immediate guide for treatment than cultures.…”

Section: Discussionmentioning

confidence: 99%