Introduction 1 2 3 Closteridium tetani C. tetani Case Report Acinetobacter baumanii Review of Literature Methods tetanus digestive system surgical procedures surgery surgical procedures operative hemorrhoids 4 Results 1 2 Table 1 Reported Cases of Gastrointestinal Procedures Complicated by Tetanus Cases References Open cholecystectomy 5 7 Cholecystectomy with exploration of bile duct 8 Resection for a gangrenous perforated small intestine 9 10 Rubber band ligation of hemorrhoids 11 Cryosurgery for internal hemorrhoids 12 Drainage of anorectal abscess 13 Sigmoidoscopic polypectomy 14 Gastrectomy, Billroth II, and transverse colectomy, (for large cell lymphoma) 15 Exploratory laparotomy (for carcinoma in omentum and liver) 5 Table 2 Summary of Presentations for the Reported Cases Author Year Age (Year) Gender (Male/Female) Time to Initial Symptoms. (Days Postprocedure) Initial Symptoms Later Symptoms Onset of Later Symptoms (Days Postprocedure) Tetanus Immunization Outcome 5 7 5 1984 47 Female 10 No mention Trismus 10 uncertain Alive 5 1984 59 Female 17 Spastic gait No mention 22 No mention Dead 6 1991 46 Male 11 Abdominal spasm, pain, fever, mild trisumus Trismus 12 No Dead 7 1984 44 No mention 6 Neck and face pain, stiffness Opisthotonus 6 No mention No mention 8 8 1984 49 Female 12 Sub-costal pain, abdominal distention Opisthotonus No mention No Alive 8 1984 66 Female 16 Abdominal pain Trismus 19 No Alive 9 10 9 1998 75 Male 1 Jerking, limb rigidity Opisthotonus 1 No Alive 10 1964 61 Male 2 Jerking Opisthotonus 4 No mention Alive 11 11 1978 33 Female 7 Dysphagia, neck pain Trismus 9 No Alive Present case 1997 63 Female 4 Dysphagia Trismus 6 No Alive 12 12 1992 42 Male 14 Fever, Dysphagia Trismus 19 No Alive 13 13 1984 62 Male 10 Restlessness, limb rigidity Trismus 12 No Alive 14 14 1969 55 Female 10 Fatigue, weakness Trismus 19 No Alive 15 15 1988 48 Male 21 Fever, abdomen, back pain, dysphagia Trismus and opisthotonus 26 No Alive 5 5 1984 65 Female 12 No mention No mention 12 No Dead Discussion 1 Clostridium tetani 1 C. tetani C. tetani C. tetani C. tetani 16 C. tetani 1 17 1 18 Conclusion Postoperative cases of tetanus have been reported after a number of different gastrointestinal procedures. Tetanus can occur after relatively minor procedures such as hemorrhoidal banding. Practicing physicians need to be aware of the clinical presentation of this deadly disease when encountered in vulnerable patient populations.