Clostridium Septicemia Following Biliary Surgery in a Gastrectomized Patient

Abstract

Aukee, S., Alhava, E. M., Koskela, E., Lahtinen, J. & Salmela, J. Clostridium septicemia following biliary surgery in a gastrectomized patient. Scand. J. Gastroent. 1975, 10, 109-111.

A 75-year-old woman was subjected to biliary surgery 38 years after partial gastrectomy for ulcer. There was a history of gallstones of 10 years duration, pentagastrin-resistant achylia, cholecystolithiasis and choledocholithiasis complicated by stenosis of papilla of Vater, cholecystitis and pancreatitis. Per-operative cholangiography and biliary tract surgery were performed. On the third postoperative day heavy jaundice and hemolysis developed, leading to death of the patient. Culture of bile taken at operation revealed strains of Clostridium perjringens and Escherichia coli. Autopsy showed a picture of gas gangraena of the liver and Clostridium septicemia. The role of achylia, blind loop, and biliary obstruction in bile surgery is stressed.

Key-words::

• Biliary surgery
• blind loop
• Clostridium perfringens
• gastrectomy