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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of hemolytic-uremic syndrome (HUS) with colonic gangrene are analyzed. Colonic gangrene is an uncommonly reported complication, and it determines a greater severity of the disease, and consequently additional therapeutic measures should be taken. One of the patients died and the survivor needed colonic resection, external ileostomy, and arteriovenous hemofiltration to overcome his renal failure. In the long term follow up this patient recovered uneventfully. The initial features were similar for most of the patients with this disease. The sudden decompensation with hypotension, toxic aspect, bulged and painful abdomen, with blood stools, could indicate this complication. The patient that was undertaken to an aggressive surgical approach had a favorable outcome. In the other patient, complications such as sepsis and septic shock were present with fatal outcome. We believe that this was in part due to the delayed surgical treatment. Reports in the literature suggest a poor prognosis in the presence of this complication, because of protracted renal damage and chronic renal failure.
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PMID:[Total necrosis of the colon as a complication of the hemolytic-uremic syndrome]. 228 68

Colonic ischaemia, commonly referred to as ischaemic colitis, is the most common type of intestinal ischaemia. The term "ischaemic colitis" was used by Marston (1966) with three typical patterns of injury described: transient reversible ischaemia, ischaemic ulcers with stricturing, and gangrenous ischaemic colitis. Dominant presenting symptoms were colicky abdominal pain, vomiting, bloody diarrhea, and hematochezia. Patients often have minimal signs on clinical examination. Most patients were diagnosed at colonoscopy. Two regions that are believed to be anatomically vulnerable to ischemic disease are "Griffith's point", at the splenic flexure and "Sudeck's critical point", of the Drummond marginal artery. Clinically, ischaemic colitis is classified as non-gangrenous or gangrenous. Non-gangrenous ischaemic colitis involves the mucosa and submucosa and accounts for 80-85 percent of all cases of ischaemic colitis. Non-gangrenous ischaemic colitis is further subclassified into transient, reversible ischaemic colitis with a less severe form of injury and chronic, non-reversible ischaemic colitis, which includes chronic colitis and stricture and has a more severe form of injury. Gangrenous ischaemic colitis accounts for the remaining 15-20 percent of cases and manifests as the most seve-re form of injury. It includes acute fulminant ischaemia with transmural infarction that may progress to necrosis and death. Specific indications for operation include peritonitis, perforation, recurrent fever or sepsis, clinical deterioration in patients refractory to me-ical management. Relative indications include fulminant colitis, massive hemorrhage, chronic protein losing colopathy, and symptomatic ischemic stricture.
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PMID:Ischaemic colitis--review. 1906 99