Bowel infarction

O Primary peritonitis develops in up to 25% of patients with alcoholic cirrhosis.3 Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) average one episode of peritonitis every 2 years.4 Secondary peritonitis may be caused by perforation of a peptic ulcer traumatic perforation of the stomach, small or large bowel, uterus, or urinary bladder appendicitis pancreatitis diverticulitis bowel infarction inflammatory bowel disease cholecystitis operative contamination of the peritoneum or diseases of the female genital tract such as septic abortion, postoperative uterine infection, endometritis, or salpingitis. Appendicitis is one of the most common causes of intraabdominal infection. In 1998, 278,000 appendectomies were performed in the United States for suspected appendicitis.5... 

Other adverse events may include pancytopenia, aplastic anemia, neutropenia, leukopenia, thrombocytopenia, lymphopenia, leukocytosis, lymphadenopathy, coagulation disturbances, hypotension/shock, heart failure, angina/MI, tachycardia, bradycardia, tachypnea/hyperventilation, abnormal chest sounds, pneumonia/pneumonitis, rash, urticaria, pruritus, erythema, flushing, diaphoresis, diarrhea, bowel infarction, arthralgia, arthritis, blindness, blurred vision, diplopia, hearing loss, otitis media, tinnitus, vertigo, photophobia, conjunctivitis, nasal/ear stuffiness, and anuria/oliguria. 

Gastrointestinal symptoms, especially diarrhea, occur after cocaine use. Cases of more severe abdominal distress have required surgical intervention and have been due to bowel infarction (1,189) or pneumoperitoneum... 

Extraperitoneal perforation and leakage of barium may cause few immediate symptoms, but delayed endo-toxic shock can develop some 12 hours later, often causing death. Bowel infarction can also result. Barium granulomata can occur, causing painful masses, rectal strictures, or ulcers. On proctoscopy, an ulcer with a whitish base can mimic a carcinoma. In one rare case, perforation of a barium enema into a sigmoid abscess was followed by intravasation into the portal venous system (11). 

Any disorder that results in necrosis of skeletal muscle cells (i.e., rhabdomyolysis) can result in the release of large amounts of intracellular phosphorus into the systemic circulation. This condition is frequently associated with acute renal failure and thus severe hyperphosphatemia may develop due to increased endogenous phosphorus release coupled with decreased renal phosphorus excretion. Bowel infarction, malignant hyperthermia, and severe hemolysis are also conditions that may increase endogenous release of phosphorus. 

Abnormal bowel anatomy or insufficient bowel. This may occur after repeated surgery for chronic di.sorders such as Crohn s disea.se or after bowel infarction and removal of the necrotic bow el. 

Abdominal distension and ileus may also be a manifestation of acute bowel infarction, a rare but catastrophic complication that results from prolonged hypotension or mesenteric artery vasospasm (caused, for ex-... 

Other complications of vasospasm include coronary ischemia and myocardial infarction, abdominal angina and bowel infarction, renal infarction and failure, visual disturbances and blindness, and stroke. Psychosis, seizures, and coma occur rarely. 

Danse E, Dewit O, Goncette L et al (2005) Que faire en cas d affection aiguE du colon Une Echographie, un scanner, des clichEs conventionnels ou une endoscopie SFR Paris octobre 2005, Formation MEdicale Continue 23 241-253 Federle MP, Chun G, Jeffrey RB, Rayor R (1984) Computed tomographic findings in bowel infarction. AJR Am J Roentgenol 142 91-95... 

A spectrum of end-organ ischemic complications can occur with embolotherapy. Bowel infarction can complicate splanchnic embolization targeting bleeding or could result from inadvertent non-target embolization from an upstream source [88]. Gallbladder infarction or bile duct necrosis can complicate hepatic artery embolization or che-moembolization [89, 90]. Splenic abscess and overwhelming sepsis can occurs following splenic embolization [91]. Skin necrosis and nerve injury have been reported as a result of ethanol embolization of vascular malformations [53, 54]. Buttock muscular necrosis, buttock claudication and sexual dysfunction can occur as a result of internal iliac branch embolization, especially when distal or bilateral [92-95]. 

Mulligan BD, Espinosa GA (1983) Bowel infarction complication of ethanol ablation of a renal tumor. Cardiovasc Intervent Radiol 6 55-57... 

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