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February 1965

Thoracoabdominal TetanusMaking of Acute Abdominal Crisis

Author Affiliations

From the Department of Surgery, University of Rochester Medical Center. Chief Resident Surgeon and Instructor in Surgery.

Arch Surg. 1965;90(2):261-265. doi:10.1001/archsurg.1965.01320080085018

THORACOABDOMINAL tetanus, a form first described by Marie1 in 1916, represents the rarest manifestation of infection due to Clostridium tetani. Approximately a dozen cases with predominantly truncal localization have been documented in the world literature. Proper diagnosis is complicated by the marked similarity between the presenting manifestations and those accompanying common causes of peritonitis. In the absence of involvement of muscle groups other than those of the abdominal wall and trunk, the differential diagnosis must include all possible causes of an "acute abdomen." As a corollary, the established presence of thoracoabdominal tetanus with persistent rigidity of the abdominal wall musculature may mask the development of an acute intra-abdominal process. The case to be reported represents a unique instance, in which an acute surgical crisis supervened unrecognized in the setting of thoracoabdominal tetanus, and resulted ultimately in the patient's demise.

Report of a Case  SMH No. 459823.—A 55-year-old white,

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