Liver Disease, Phlegmonous Colitis, and Gram-Negative Sepsis

Mendeloff, Joseph; Wenger, Julius

doi:10.1097/00007611-197504000-00027

Cited by 14 publications

(10 citation statements)

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“…The patient in our case study had a history of chronic liver disease with established cirrhosis secondary to hepatitis C and alcohol. The association between phlegmonous colitis and chronic liver disease is well described 1–6 . Reported aetiologies include epidemic hepatitis, 3 alcohol 2,4–6 and fatty change 5,6 .…”

Section: Blood Panel (Reference Range In Brackets)mentioning

confidence: 99%

“…The association between phlegmonous colitis and chronic liver disease is well described 1–6 . Reported aetiologies include epidemic hepatitis, 3 alcohol 2,4–6 and fatty change 5,6 . All of Satoh's 13 cases had hepatic diseases – cirrhosis in 11 (84.6%) and acute exacerbation of chronic hepatitis in 2 (15.4%).…”

Section: Blood Panel (Reference Range In Brackets)mentioning

confidence: 99%

“…One study has shown increased intestinal permeability in cirrhotics 9 . Several reports, however, have failed to demonstrate mucosal ulcerations or necrosis 1,3,6,7 . Indeed, Satoh's analysis of all autopsy cases with inflammatory lesions in the large bowel concluded that submucosal bacterial infection in the absence of microscopically detectable mucosal injuries appear to be histologically specific to phlegmonous colitis 1 .…”

Section: Blood Panel (Reference Range In Brackets)mentioning

confidence: 99%

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A fatal case of phlegmonous colitis in chronic hepatitis C receiving combination interferon and ribavirin therapy

Pang¹,

Silva

Napoli³

et al. 2009

Internal Medicine Journal

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Phlegmonous colitis is an acute suppurative infection of the large bowel that is rarely described, rapidly fatal and often escapes clinical attention. Patients with chronic hepatic diseases appear to be predisposed to this condition. We report a novel case of fatal phlegmonous colitis in a cirrhotic patient receiving combination pegylated interferon and ribavirin for chronic hepatitis C, highlighting the importance of early recognition of this aggressive infectious entity.

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Section: Blood Panel (Reference Range In Brackets)mentioning

confidence: 99%

Section: Blood Panel (Reference Range In Brackets)mentioning

confidence: 99%

Section: Blood Panel (Reference Range In Brackets)mentioning

confidence: 99%

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A fatal case of phlegmonous colitis in chronic hepatitis C receiving combination interferon and ribavirin therapy

Pang¹,

Silva

Napoli³

et al. 2009

Internal Medicine Journal

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“…The literature in English has reported about 60 cases. The association between this disease entity and a variety of liver diseases has been well documented (1-3), though cases associated with lobar pneumonia, pharyngitis, infected peritoneojugular venous shunt and septicemia have been reported, and it has also occurred in healthy individuals (1, 4-6). Pathologically, it is defined as diffuse inflammation localized in the submucosa.…”

Section: Discussionmentioning

confidence: 99%

Phlegmonous Enteritis in a Patient with Congestive Heart Failure and Colon Cancer

et al. 2001

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Phlegmonous enteritis is a rare infective inflammatory disease of the intestine, predominantly involving the submucosal layer. It is difficult to diagnose and often fatal. Its association with alcoholism and various liver diseases, although rarely reported, is well documented. We report a case of phlegmonous enteritis in a male patient with congestive heart failure and colon cancer, and describe the ultrasonographic and CT findings.

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“…Phlegmonous colitis (PC) was first recognized in 1975 as a source of bacteraemia in patients with end-stage liver disease [5]. In 2009, PC remains almost exclusively an autopsy finding, and was actually detected post-mortem in 2.5% of patients with cirrhosis: thirteen autopsy cases showed some or all of the following clinico-pathologic characteristics: (1) preferential involvement of the cecum; (2) phlegmonous changes in the submucosa; and (3) bacterial infection [6,7].…”

Section: Introductionmentioning

confidence: 99%

Phlegmonous colitis: another source of sepsis in cirrhotic patients?

et al. 2009

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BackgroundThe 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 presentationWe 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.ConclusionsThese 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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Liver Disease, Phlegmonous Colitis, and Gram-Negative Sepsis

Cited by 14 publications

References 0 publications

A fatal case of phlegmonous colitis in chronic hepatitis C receiving combination interferon and ribavirin therapy

A fatal case of phlegmonous colitis in chronic hepatitis C receiving combination interferon and ribavirin therapy

Phlegmonous Enteritis in a Patient with Congestive Heart Failure and Colon Cancer

Phlegmonous colitis: another source of sepsis in cirrhotic patients?

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