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Necrotic colitis in the presence of normal vascularization of the colon

Archivum Chirurgicum Neerlandicum
|January 1, 1976
PubMed

Insights

Fulminant necrotic colitis, a severe form of ischemic colitis, can occur without mesenteric vessel obstruction, often in patients with heart disease. This case highlights its occurrence in hemorrhagic shock, potentially involving Gram-positive rods.

Area of Science:

  • Gastroenterology
  • Vascular Surgery
  • Pathology

Background:

  • Necrotic colitis, a severe ischemic colitis, typically lacks organic mesenteric obstruction.
  • It is often associated with pre-existing cardiopathy and rarely occurs due to hypotension, hypovolemia, or sepsis.

Observation:

  • A rare case of total colonic gangrene is presented in a patient experiencing hemorrhagic shock.
  • This observation challenges typical etiologies of non-occlusive intestinal infarction.

Findings:

  • The study postulates that fulminant colonic gangrene may be co-induced by Gram-positive rods.
  • These bacteria are detectable even in the deeper layers of the colonic wall.

Implications:

  • This finding suggests a potential infectious component in non-occlusive ischemic colitis.
  • Understanding this etiology is crucial for managing high-mortality cases of necrotic colitis.

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