Phlegmonous colitis: another source of sepsis in cirrhotic patients?

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). We report three cirrhotic patients who were admitted with abdominal sepsis a...

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Bibliographic Details
Published in:BMC gastroenterology 2009-12, Vol.9 (1), p.94-94, Article 94
Main Authors: Holzer, Thomas, Gervaz, Pascal, Spahr, Laurent, McKee, Thomas, Bucher, Pascal, Morel, Philippe
Format: Article
Language:English
Subjects:
Adult
Aged
Anti-Bacterial Agents - therapeutic use
Care and treatment
Case Report
Case studies
Cellulitis - complications
Cellulitis - diagnosis
Cellulitis - therapy
Colectomy - methods
Colitis
Colitis - complications
Colitis - diagnosis
Colitis - therapy
Colon - pathology
Colon - surgery
Complications and side effects
Diagnosis
Diagnosis, Differential
Fatal Outcome
Follow-Up Studies
Gastroenterology
Humans
Hypertension
Intestinal Mucosa - pathology
Liver cirrhosis
Liver Cirrhosis - complications
Liver Cirrhosis - diagnosis
Male
Risk factors
Sepsis - diagnosis
Sepsis - etiology
Sepsis - therapy
Tomography, X-Ray Computed
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Summary: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). 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. These data suggest that cirrhotic patients with PHC may progress towards PC, which, in turn, may be the cause for life-threatening sepsis.
ISSN:1471-230X
1471-230X
DOI:10.1186/1471-230X-9-94