Enteritis necroticans with midgut necrosis caused by Clostridium perfringens

L. E. Clarke, B. Diekmann-Guiroy, W. McNamee, D. J. Java Jr and S. M. Weiss
Mercy Catholic Medical Center, Misericordia Division, Philadelphia, Pa.

Enteritis necroticans is a necrotizing process manifesting as segmental gangrene of the bowel, triggered by Clostridium perfringens toxins under specific dietary conditions. It is a rare disease in developed countries and is probably underdiagnosed. A case of enteritis necroticans presenting with midgut necrosis with sepsis and hemolysis is reported herein. Bacteriologic culture of blood and peritoneal content revealed C perfringens. Dietary history, including the ingestion of meat together with sweet potatoes, should increase clinical suspicion of enteritis necroticans. Early recognition and timely surgical intervention are required for successful treatment. Clinicians are encouraged to be aware of this clinically fulminant yet rarely recognized surgical entity.