PMID: 9163265Mar 1, 1997Paper

Generalized gas gangrene infection with rhabdomyloysis following cholecystectomy

Der Anaesthesist
W HaertyJ Briegel

Abstract

We report a rare case of spontaneously developing generalised gas gangrene with massive rhabdomyolysis after a cholecystectomy and drainage of a hepatic abscess. On preoperative physical examination the patient appeared severely ill and was icteric and oliguric. Laboratory evaluation showed signs of systemic inflammation, elevated lactate levels, evidence of disseminated intravascular coagulation (DIC), and increased levels of serum creatine kinase (CK) activity. Abdominal ultrasound and endoscopic retrograde cholangiography showed a gallbladder perforation and a hepatic abscess. Cholecystectomy and drainage of the abscess was performed immediately and without technical problems. After postoperative admission to the intensive care unit, the patient showed evidence of generalised myonecrosis with subcutaneous gas formation and acute renal failure. Initially, there were few other signs of systemic toxicity; the patient was not hypotensive and the pulmonary gas exchange was normal. Within hours diffuse swelling of his right leg developed with cutaneous gangrene and a compartment syndrome. After fasciectomy and extensive surgical debridement, uncontrollable bleeding due to DIC developed from the fasciectomy site, which finally requ...Continue Reading

Citations

Jan 28, 2017·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·D Seidel, J Bunse
Aug 5, 2016·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Annelieke M K HarmsenL Maurits de Brauw
Aug 22, 2009·ANZ Journal of Surgery·Petr LochmanMichal Plodr
Sep 8, 2006·World Journal of Surgery·H W NijhofH H Hartgrink
Sep 9, 2004·Surgical Infections·Hendrik BergertDetlef Ockert
Nov 20, 2019·Journal of Clinical Neuromuscular Disease·Josef FinstererCarla A Scorza

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