ABSTRACT
Apart from pseudomembranous colitis (PMC) and pneumatosis cystoides intestinalis (PCI), the pathology of clostridial bowel disease is one dominated by progressive hemorrhagic necrosis and submucosal edema. In some cases clostridial species have been cultured and Gram-positive rods seen in large numbers on the necrotic mucosal surface or to a lesser degree in the submucosa. Adult disease may be divided into primary and secondary types. Secondary disease is usually associated with chronic pulmonary disease or chronic peptic ulceration, and the lesions predominate on the serosal aspect of the bowel. In primary or idiopathic PCI the submucosa is involved and the bowel has a spongy texture even though nothing may be visible externally. Neonatal necrotizing enterocolitis condition incorporates the basic pathology of PCI accompanied by a severe mucosal inflammatory reaction and necrosis. Reflecting the severity of the pathology is the fact that most patients present as abdominal surgical emergencies though a clinical as well as a pathological spectrum exists.
