LIVER-CIRRHOSIS WITH SYNCHRONOUS GAS-GANGRENE AND SPONTANEOUS BACTERIAL PERITONITIS DUE TO ESCHERICHIA-COLI

We report a case of synchronous gas gangrene and spontaneous bacterial peritonitis associated with liver cirrhosis. The patient was a 52-yea r-old man who was being followed for decompensated liver cirrhosis. He experienced sudden onset lower abdominal pain with distension and pai n in the left leg. A bullous lesion, with crepitation, later appeared in the thigh and showed air-bubbles on X-ray. Eschericia coli was cult ured from ascites and the bullous lesions; there was associated gas ga ngrene. The patient died of bacteremia with disseminated intravascular coagulopathy 26 h after admission, despite receiving intensive care. We discuss the route of bacteria causing the spontaneous bacterial per itonitis and simultaneous gas gangrene.