Radiographic Manifestations of Clostridial Infection Encountered at Queen Elizabeth Hospital,Adelaide

Cases of cholecystitis emphysematosa, ante-mortem gas in the portal venous system, and primary clostridial pneumonia were presented and literature reviewed. No gall-stones were demonstrated in the cholecystitis emphysematosa, demonstrating that obstruction of the cystic duct is not an essential aetiological factor. This patient was not a diabetic. The case of the gas in the portal venous system is of particular interest as the portal sepsis was an aftermath of perforation of primary non-specific jejunal ulcer which in the opinion of clinicians and pathologists involved was secondary to sarcoid granuloma. This patient was a diabetic. There was no evidence of mesenteric artery occlusion, pneumatosis intestinalis or gross distension of loops of bowel, thus lending support to the theory of sepsis of the portal venous system by gas-producing organisms. The primary clostridial pneumonia in the patient suffering from acute myeloid leukaemia was diagnosed at autopsy. This was characterized radiographically by dense consolidation of the right upper lobe, which within 18 hours progressed to widespread abscess formation.