Abstract
We have encountered an autopsy case of severe acute pancreatitis caused by Clostridium perfringens infection accompanied by pneumoretroperitoneum. A 79-year-old man was admitted to our hospital owing to acute abdominal pain. Computed tomography of the abdomen showed a large amount of gas accumulation in the retroperitoneal space around the pancreatic head and body. He was suspected of having severe acute pancreatitis accompanied by pneumoretroperitoneum or acute pancreatitis followed by perforation of the upper digestive tract. Despite conservative treatment with intense care, he died owing to sepsis and circulatory failure three days after the onset. The autopsy findings revealed massive necrosis and bleeding in the pancreatic head and body. Clostridium perfringens and Enterococcus faecium were isolated by culture of pancreatic and hepatic necrosis tissues. We concluded that the patient suffered from severe acute pancreatitis caused by Clostridium perfringens infection accompanied by pneumoretroperitoneum. Because pancreatitis and sepsis caused by Clostridium perfringens infection develop and worsen rapidly, it is important to start the treatment at an early stage.
