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Carcinoma of the large intestine and nontraumatic, metastatic, clostridial myonecrosis
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Carcinoma of the large intestine and nontraumatic, metastatic, clostridial myonecrosis
作者:
Wesley Furste,
Melinda Dolor,
Lawrence Rothstein,
Gregory Vest,
期刊:
Diseases of the Colon & Rectum
(OVID Available online 1986)
卷期:
Volume 29,
issue 12
页码: 899-904
ISSN:0012-3706
年代: 1986
出版商: OVID
关键词: Carcinoma of large intestine;Nontraumatic myonecrosis;Metastatic myonecrosis;Clostridial myonecrosis;Myonecrosis;Gas gangrene;Gangrene;Gas in tissues;Infections, gangrenous
数据来源: OVID
摘要:
&NA;Traumatic, clostridial myonecrosis is a rare and serious complication of wounds. Nontraumatic, metastatic, clostridial myonecrosis may be caused by carcinoma of the large intestine. Nontraumatic myonecrosis becomes evident with localized pain, generalized toxicity, local signs of inflammation, and crepitation. Serum creatine kinase determinations may be of help in diagnosing patients suspected of having acute myonecrosis. Immediate heroic surgical intervention, usually with demonstration ofClostridium septicum, is mandatory to control the myonecrosis. Appropriate antibiotic therapy is a valuable adjunct to surgical intervention, and penicillin in massive doses appears to be the agent of choice for the clostridia. Hyperbaric oxygen therapy may help in the optimal control. General supportive measures, including frequent blood transfusions, are most important. To save the life of the patient with nontraumatic, metastatic, clostridial myonecrosis, it is necessary, as soon as the patient's general condition permits, to diagnose and eliminate the cause of the myonecrosis. In addition to the case reported, 16 cases have been reported in the literature, making a total of 17. Five patients have survived (survival rate, 29 percent).
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