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Phlegmonous colitis: another source of sepsis in cirrhotic patients?

Published in BMC Gastroenterology. 2009, vol. 9, 94
Abstract BACKGROUND: The clinical relevance of phlegmonous colitis (PC), a rare autopsy finding in cirrhotic patients, is poorly documented. We postulated that PC might be a source of sepsis in patients with portal hypertensive colopathy (PHC). CASE PRESENTATION: We report three cirrhotic patients who were admitted with abdominal sepsis and who illustrate, to various degrees, the clinico-pathological sequence of colonic alterations associated with portal hypertension. Two cirrhotic patients with PHC developed gram-negative bacteraemia and quickly responded to intravenous antibiotics. Another cirrhotic patient underwent emergency colectomy for PC, and subsequently died from multiple organ failure. Histological alterations in the operative specimen included: a) mucosal ulcerations; b) disseminated micro-abscesses in the submucosa; and c) a severe vasculopathy leading to complete obliteration of submucosal blood vessels. CONCLUSIONS: These data suggest that cirrhotic patients with PHC may progress towards PC, which, in turn, may be the cause for life-threatening sepsis.
Keywords AdultAgedAnti-Bacterial Agents/therapeutic useCellulitis/*complications/diagnosis/therapyColectomy/methodsColitis/*complications/diagnosis/therapyColon/pathology/surgeryDiagnosis, DifferentialFatal OutcomeFollow-Up StudiesHumansIntestinal Mucosa/pathologyLiver Cirrhosis/*complications/diagnosisMaleSepsis/diagnosis/*etiology/therapyTomography, X-Ray Computed
PMID: 20003486
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Research groups Chirurgie viscérale (104)
Chirurgie viscérale (HUG)
Lymphomes MALT et réplication virale (807)
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HOLZER, Thomas et al. Phlegmonous colitis: another source of sepsis in cirrhotic patients?. In: BMC Gastroenterology, 2009, vol. 9, p. 94. doi: 10.1186/1471-230X-9-94 https://archive-ouverte.unige.ch/unige:19541

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Deposited on : 2012-04-23

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