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Phlegmonous colitis: another source of sepsis in cirrhotic patients?
|Published in||BMC Gastroenterology. 2009, vol. 9, p. 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||Adult — Aged — Anti-Bacterial Agents/therapeutic use — Cellulitis/*complications/diagnosis/therapy — Colectomy/methods — Colitis/*complications/diagnosis/therapy — Colon/pathology/surgery — Diagnosis, Differential — Fatal Outcome — Follow-Up Studies — Humans — Intestinal Mucosa/pathology — Liver Cirrhosis/*complications/diagnosis — Male — Sepsis/diagnosis/*etiology/therapy — Tomography, X-Ray Computed|
|Research groups||Chirurgie viscérale (104)|
Lymphomes MALT et réplication virale (807)
|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|