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Phlegmonous colitis: a specific and severe complication of chronic hepatic disease

T Satoh1, E Sasatomi, L Wu

  • 1Department of Pathology, Saga Medical School, Japan. satoht2@post.saga-med.ac.jp

Virchows Archiv : an International Journal of Pathology
|February 24, 2001
PubMed

Insights

Phlegmonous colitis (PC), a bacterial infection, was found in 0.15% of autopsy cases. It frequently occurred in patients with liver disease, often without prior suspicion, indicating it

Area of Science:

  • Gastroenterology
  • Pathology
  • Infectious Diseases

Background:

  • Phlegmonous colitis (PC) is an acute bacterial infection.
  • Liver diseases, such as cirrhosis, are associated with increased risk.
  • PC is often undiagnosed before autopsy.

Purpose of the Study:

  • To determine the prevalence and characteristics of phlegmonous colitis in autopsy cases.
  • To identify potential risk factors and common pathological features of PC.
  • To highlight PC as an unrecognized complication in patients with hepatic diseases.

Main Methods:

  • Review of 8,822 autopsy cases.
  • Identification and analysis of 13 cases of phlegmonous colitis.
  • Examination of pathohistologic characteristics, including site of involvement, inflammation, bacterial presence, mucosal integrity, and associated conditions like serositis.

Main Results:

  • Phlegmonous colitis was identified in 13 cases (0.15%) of the 8,822 autopsies.
  • PC occurred in 2.43% of patients with hepatic cirrhosis or subacute liver atrophy.
  • Common features included cecal involvement (76.9%), submucosal inflammation/edema (100%), bacterial infection (100%), and often intact mucosa (92.3%).

Conclusions:

  • Phlegmonous colitis is an unrecognized, potentially fatal complication in patients with hepatic diseases.
  • PC shares pathohistologic similarities with spontaneous bacterial peritonitis in animal models.
  • The findings suggest PC arises from spontaneous infection in patients with liver cirrhosis.

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