Fulminant and fatal gas gangrene of the stomach in a healthy live liver donor

Liver Transpl. 2004 Oct;10(10):1315-9. doi: 10.1002/lt.20227.

Abstract

A 57-year-old male with a history of hypercholesterolemia and anxiety but otherwise in good health volunteered to donate the right lobe of his liver to his brother. The operation was performed uneventfully, without transfusion. Postoperatively he did well, until he developed tachycardia, profound hypotension, and coffee ground emesis on postoperative day 3. Despite resuscitative measures, he arrested and expired. Autopsy demonstrated gas gangrene of the stomach as the underlying cause of the hemorrhage and numerous colonies of Gram-positive bacilli were identified. Subsequent polymerase chain reaction (PCR) analysis identified these bacteria to be Clostridium perfringens (C. perfringens) type D. This patient's death was devastating, both to his family and his medical team. The impact of his death has transcended that of an individual occurrence. In conclusion, herein we present the facts and discuss this extraordinary example of florid clostridial infection and toxin-mediated shock. It was completely unexpected and probably unpreventable, and its cause was almost inconceivable.

Publication types

  • Case Reports

MeSH terms

  • Clostridium perfringens / isolation & purification*
  • Fatal Outcome
  • Gas Gangrene / complications
  • Gas Gangrene / etiology*
  • Gas Gangrene / microbiology
  • Gastritis / etiology
  • Hematemesis / etiology*
  • Humans
  • Liver Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Stomach Diseases / complications
  • Stomach Diseases / etiology*
  • Stomach Diseases / microbiology
  • Tissue and Organ Procurement