An autopsy case of fulminant sepsis due to pneumatosis cystoides intestinalis

摘要: A 67-year-old female with uncontrolled diabetes mellitus (DM) was admitted to a hospital because of sudden onset mid-abdominal pain. Laboratory data only showed mild elevation white blood cell counts. She diagnosed as constipation, and given laxative enema. However, 9 h after the admission, her pressure suddenly went down developing metabolic acidosis, died 20 admission. Forensic autopsy revealed massive pneumohemia in venous system. Edematous dark-brown colored lesions mucosal surface were discontinuously observed from terminal ileum sigmoid colon bloody ascites. Histopathological findings gas cysts lymphoid infiltration within colonic submucosa compatible pneumatosis cystoides intestinalis (PCI). Anaerobes positive culture. From clinical histological findings, we hypothesized that PCI initially occurred, intestinal bacterias invaded into vessels through broken barrier developed fulminant sepsis. In recent years, anaerobic bacteremia has reemerged significant problem due increasing number patients complex underlying disease such malignancy, liver cirrhosis, DM so on. forensic infection should be considered particularly immuno-compromised hosts total judgment would essential.