Clostridial enteritis necroticans versus secondary clostridial infection superimposed upon ischemic bowel disease

Clostridial enteritis necroticans, or pig-bel, as seen in Papua New Guinea, is a necrotizing, segmental gangrene of the small intestine occurring in members of a malnourished population, who become ill after consuming large quantities of pork contaminated with Type C. Clostridium perfringens. We report a case of possible Clostridial enteritis necroticans with concomitant ischemic intestinal disease secondary to superior mesenteric arterial thrombosis occurring in a 53-year-old woman with a long history of diabetes mellitus, hypertension, and peripheral vascular disease. The differential diagnosis and the pathogenesis of C. perfringens enteritis necroticans are discussed.