Case 63.  Clostridial gas gangrene of pancreas (66 y-o M)
         
    Autopsied fulminant pancreatitis in a diabetic man, showing two-day clinical course    
         
   
Key words :  gas gangrene, pancreatitis, Clostridium spp.
   
     
 
     
Abdominal CT demonstrates gas retention in the bile duct in the left lobe of the liver and in the abdominal cavity. No pancreas is seen in this film.   Features of acute hemorrhagic pancreatitis with heavy infiltration of neutrophils are observed (HE, low power).
     
 
     
Clusters of short rods are seen in the central necrotic area. The bacteria are seen along the pancreatic duct. Neutrophilic reaction is hardly seen in this area (HE, high power).   The rods are Gram-positive and consistent with Clostridium species (Gram).
     
 
     
Reference case 63A
Another case of pancreatic gas gangrene in a diabetic male (Gram). Numerous Gram-positive long rods are observed around the gas-filled space formed in the necrotic pancreas, confirming the diagnosis of Clostridium perfringens infection.
  Reference case 63A
Gross findings of the liver in case of pancreatic gas gangrene. The cut surface of the formalin-fixed liver shows numerous gas-filled spaces, giving a characteristic spongy appearance.