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Phlegmonous colitis: another source of sepsis in cirrhotic patients?

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 a...

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Autores principales: Holzer, Thomas, Gervaz, Pascal, Spahr, Laurent, McKee, Thomas, Bucher, Pascal, Morel, Philippe
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800109/
https://www.ncbi.nlm.nih.gov/pubmed/20003486
http://dx.doi.org/10.1186/1471-230X-9-94
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author Holzer, Thomas
Gervaz, Pascal
Spahr, Laurent
McKee, Thomas
Bucher, Pascal
Morel, Philippe
author_facet Holzer, Thomas
Gervaz, Pascal
Spahr, Laurent
McKee, Thomas
Bucher, Pascal
Morel, Philippe
author_sort Holzer, Thomas
collection PubMed
description 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.
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spelling pubmed-28001092009-12-31 Phlegmonous colitis: another source of sepsis in cirrhotic patients? Holzer, Thomas Gervaz, Pascal Spahr, Laurent McKee, Thomas Bucher, Pascal Morel, Philippe BMC Gastroenterol Case Report 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. BioMed Central 2009-12-15 /pmc/articles/PMC2800109/ /pubmed/20003486 http://dx.doi.org/10.1186/1471-230X-9-94 Text en Copyright ©2009 Holzer et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Holzer, Thomas
Gervaz, Pascal
Spahr, Laurent
McKee, Thomas
Bucher, Pascal
Morel, Philippe
Phlegmonous colitis: another source of sepsis in cirrhotic patients?
title Phlegmonous colitis: another source of sepsis in cirrhotic patients?
title_full Phlegmonous colitis: another source of sepsis in cirrhotic patients?
title_fullStr Phlegmonous colitis: another source of sepsis in cirrhotic patients?
title_full_unstemmed Phlegmonous colitis: another source of sepsis in cirrhotic patients?
title_short Phlegmonous colitis: another source of sepsis in cirrhotic patients?
title_sort phlegmonous colitis: another source of sepsis in cirrhotic patients?
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800109/
https://www.ncbi.nlm.nih.gov/pubmed/20003486
http://dx.doi.org/10.1186/1471-230X-9-94
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