Department of Surgery, Geneva University Hospital and Medical School, 1211 Geneva, Switzerland.
BMC Gastroenterol. 2009 Dec 15;9:94. doi: 10.1186/1471-230X-9-94.
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.
蜂窝织炎（PC）是肝硬化患者尸检中罕见的发现，其临床相关性尚未得到充分证实。我们推测 PC 可能是门脉高压性结肠病（PHC）患者脓毒症的来源。
我们报告了三例因腹部感染入院的肝硬化患者，他们在不同程度上说明了与门脉高压相关的结肠改变的临床病理序列。两名患有 PHC 的肝硬化患者发生革兰氏阴性菌血症，并迅速对静脉内抗生素产生反应。另一名肝硬化患者因 PC 而行紧急结肠切除术，随后死于多器官功能衰竭。手术标本的组织学改变包括：a）黏膜溃疡；b）黏膜下弥漫性微脓肿；c）严重的血管病变导致黏膜下血管完全闭塞。
这些数据表明，患有 PHC 的肝硬化患者可能会进展为 PC，而 PC 反过来又可能是危及生命的脓毒症的原因。
