Friday, November 16, 2007

Pigbel


Meet Gason, Becky admitted him last night with Pigbel. Enteritis necroticans - - pigbel, is a disease that is found here in the Highlands of PNG. It is caused by Clostridium Perfringens type C. This occurs in malnourished kids after eating a protein meal that is infected with this bacteria. Usually it occurs after eating undercooked pig - hence the name, which is a common food for PNGers here. It also occurs after eating dog, goat, and peanuts. The condition is exacerbated by eating kaukau - a staple food for PNGers here. Malnutrition decreases the production of trypsin which helps to digest proteins, kaukau is a trypsin inhibitor, which only makes this condition worse. Gason had eaten goat on Friday and started with abdominal pain on Sunday. He didn't present until Thursday with abdominal distension, fever, and pain. He was admitted, started on antibiotics, IVFs and got a NGT placed. After having more abdominal distension, decreased bowel sounds, and lots of NG output - he was taken to surgery this afternoon. He had the classic findings on surgery - tiger striping of the small bowel, skip lesions, adenopathy, mucosal erosions, and necrotic small bowel. Thankfully for him he didn't perforate, so we keep praying for God to heal him. There use to be a vaccine that was given to kids, but this is no longer available here in PNG, so we will keep seeing this condition. Thankfully not everyone needs surgery, the mortality rate for surgery is 50%. IVFs, antibiotics, bowel rest and prayers are all that some patients need.