[Acute multiple organ failure after endoscopic polypectomy]

Serious intraabdominal infections belong among life treating diseases. They are based on spreading infections from focal sources of inflammation in abdomen or damaged intestinal wall.

Treatment strategies are surgical intervention, antimicrobial therapy, distributional shock treatment and accurate nutritional support (1). Glutamine and selenium supplementation may improve intestinal functions and restore antioxidant defence (2). Septic shock with multiple organ failure accompanied by serious catabolism and decrease of albumin had developed in a patient after endoscopic polypectomy. Infection source was not discovered by medical imaging examinations non surgical laparotomy. After distributive shock treatment, wide spectral antibiotics and enteral and parenteral nutrition the patients health improved. As adjuvant therapy intravenous supplementation was administered: glutamine in daily dose 2g and sodium selenite in continual infusion in daily dose 750 μg over 6 days. During intensive therapy, inflammatory markers decreased: C-reactive protein, procalcitonin, leukocyte count and neutrophils. Albumin levels increased.

The paper describes therapeutic options during septic shock treatment and reversion possibilities in the catabolic phase of disease.Key words: colonoscopy, septic shock, multiorgan failure, enteral nutrition, parenteral nutrition.