Acute gastroduodenal lesions related to severe sepsis

To determine the incidence of acute gastroduodenal lesions during severe sepsis, prospective endoscopies were performed in two groups of critically ill patients. The criteria of selection ruled out the incidence of other factors, such as shock, acute renal or respiratory failure. Evaluation of sepsis by clinical and bacteriologic criteria and endoscopic examination were performed in a double blind study. In the group of 14 patients with sepsis, 19 fibroscopies showed abnormalities of mucosa in all of them. In the group of 16 patients with sepsis, 23 fibroscopies showed either superficial lesions or normal mucosa. The difference between the incidence and the severity of acute lesions in the two groups studied was highly significative, p less than 0.001. Besides, gastroduodenal lesions became worse when sepsis prolonged, while they improved dramatically when focal infection and septicemia were eradicated. These data strongly suggest that severe sepsis per se can provoke acute digestive damage.