RESUMO
INTRODUCTION: Abdominal gas gangrene caused by Clostridium perfringens is a rare differential diagnosis to pneumoperitoneum caused by bowel perforation. There are only a handful of case reports on this topic. PATIENTS AND METHODS: We present the case of a 58 year old cirrhotic patient who represented to our ER after complicated surgery for retroperitoneal liposarcoma. On admission he complained of abdominal pain and mild fever. Due to leukocytosis and CRP a CT scan was performed which showed extensive free air. The patient was taken to the OR for suspected bowel perforation. No perforation could be identified after extensive search and lavage. RESULTS: Twelve hours after surgery microbiology reported extensive growth of clostridium perfringens in the cultures drawn from ascites. The patient was successfully treated with antibiotics and discharged home soon after. CONCLUSION: Gas gangrene is a rare differential diagnosis to bowel perforation. Most reported cases are from cirrhotic patients. If no perforation can be identified in the OR postoperative antibiotics should cover clostridium perfringens.
