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June 1956

Pseudomembranous Enterocolitis: Its Etiology and the Mechanism of the Disease Process

AMA Arch Surg. 1956;72(6):977-983. doi:10.1001/archsurg.1956.01270240089013

During the past few years increasing clinical evidence has been gathered to seriously implicate Micrococcus pyogenes (Staphylococcus aureus) as the etiological agent responsible for the often fatal surgical complication known as pseudomembranous enterocolitis. This disease entity has been most frequently described as a necrotizing colitis or enteritis following major abdominal surgery in cases where intestinal antibiotics have been used as preoperative preparations.

It is incorrect to associate this serious complication exclusively with abdominal operations or with the use of intestinal antibiotics. The disease has been observed after operations other than on the intestine. Dixon and Weismann1 reported the development of necrotizing enterocolitis following operations on the brain, breast, uterus, gall bladder, and stomach. Our own report2 included two cases of fatal enteritis following simple cholecystectomy in one and vagotomy with gastrojejunostomy in the other. There is ample evidence that the disease may occur without the use of antibiotics.