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September 1964

Clostridium Perfringens Infection: A Complication of Gallbladder Surgery

Author Affiliations

Assistant Clinical Professor of Surgery, University of Minnesota (Dr. Plimpton).

Arch Surg. 1964;89(3):499-507. doi:10.1001/archsurg.1964.01320030089015

Infections associated with gas-producing organisms are known to be among the most serious that may befall a patient. Traditionally one associates these infections with contused, contaminated injuries such as battle casualties and automobile accidents. Abdominal operations complicated by infection by members of the Clostridium genus are considered to be quite unusual, but a surprising number are reported in the surgical literature. It is not difficult to understand how this type of infection might complicate a surgical procedure in which the operative field is soiled by intestinal contents; but in gallbladder surgery, where one feels at a safe distance from the flora of the gastrointestinal tract, the presence of a Cl perfringens infection constitutes a definite enigma. At times this infection is associated with acute cholecystitis and obviously was present before surgery; at other times it becomes manifest in the early postoperative period following an elective cholecystectomy. Early diagnosis and vigorous