A 46-year-old man complaining of abdominal distension and massive bloody bowel discharges was brought into our facility by ambulance. On admission, the patient's consciousness was alert and had no fever or symptoms of shock. Blood test showed no signs suggestive of hemolysis. Abdominal ultrasonography showed significant enteric dilatation, edema of the intestinal wall, and collection of ascites. The patient went into cardiopulmonary arrest just before the end of the X-ray examination, but we were able to resuscitate. An abdominal contrast-enhanced CT scan showed extensive intestinal necrosis with portal venous gas, leading to urgent laparotomy. The entire intestine significantly dilated and an ileum by about-one meter in length became necrotic, though ascites was yellow and transparent. We performed partial ileum resection, but the patient underwent cardiac arrest again by the end of the operation. While performing cardiopulmonary resuscitation, we started percutaneous cardio-pulmonary support and endotoxin adsorption therapy by polimyxin B immobilized fiber column direct hemoperfusion in the ICU. Although we continued intensive care, the patient died approximately seven and a half hour after admission. The resected ileum contained widespread pseudomembranous hemorrhagic enteritis and the ileal necrosis had extended to the full thickness of the intestine. The histopathological diagnosis was made as Clostridium perfringens infection on immunostaining. We report the case with a review of 24 domestic cases of the disease which rapidly followed a fatal course after admission.