Tetanus Arising From Gangrenous Unperforated Small Intestine

Abstract

TETANUS is a calamitous postoperative complication. Its rarity may be inferred from a report of Christensen and Thurber¹who described 91 tetanus patients treated at the Mayo Clinic prior to 1957; only three were postoperative cases and none had undergone intestinal surgery. <i>Clostridium tetani</i>inhabits the intestinal tracts of a certain proportion of the general population. Meyer and Spector²found that stools of 10% of Chicago patients routinely admitted for hernia repair contained this organism. As long ago as 1909, Matas³found that 5% of the population generally and 20% of those working with horses carried the organism in their intestines. He pointed out that tetanus infection in wounds exposed to fecal contamination was not rare, and reported a patient who developed fatal tetanus after a hemorrhoidectomy and perineoplasty. Bunch and Quattlebaum⁴in 1943 reported eight cases of postoperative tetanus without bacteriological studies. Although they attributed