title: Fatal Clostridium perfringens Septicemia After Colonoscopic Polypectomy, Without Bowel Perforation.
abstract: Since its introduction, colonoscopy has played an important role as a diagnostic, therapeutic, and screening tool. In general, colonoscopy is regarded as a safe procedure, but complications may occur. The most dreaded of these complications is colonic perforation. Bacteremia postprocedure may occur, and although it is not uncommon, it rarely results in clinically significant complications. Patients with IBD (inflammatory bowel disease) are a high-risk population for bacteremia, which may leads to bowel wall overstepping by the bacteria. With regard to that, we report a fatal case of gas gangrene complicating colonoscopy polypectomy without bowel perforation in a healthy adult. To the best of our knowledge, only two other cases of retroperitoneal gas gangrene associated with colonoscopy polypectomy without bowel perforation have been described in international literature, but none of which was completed by a molecular biology analysis.
authors.affiliation: School of Legal Medicine, University of Perugia, P.le Severi 1, Perugia, 06121, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Gioia
authors.affiliation: School of Legal Medicine, University of Perugia, P.le Severi 1, Perugia, 06121, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lancia
authors.affiliation: Section of Microbiology, University of Perugia, P.le Severi 1, Perugia, 06126, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Mencacci
authors.affiliation: School of Legal Medicine, University of Perugia, P.le Severi 1, Perugia, 06121, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Bacci
authors.affiliation: Section of Legal Medicine, University of Perugia, via T. di Joannuccio snc, Terni, 05100, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Suadoni
mesh_terms: D003016:Clostridium perfringens / Q000302:isolation & purification / Q000472:pathogenicity*; D003113:Colonoscopy / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005738:Gas Gangrene / Q000209:etiology*; D006801:Humans; D007416:Intestinal Perforation; D008875:Middle Aged; D012187:Retroperitoneal Space; D018805:Sepsis
keywords: 
  Clostridium perfringens
  ; autopsy; colonoscopy; forensic science; gas gangrene; myonecrosis; polypectomy; retroperitoneal