title: [Septic shock with acute abdomen in idiopathic hemochromatosis].
abstract: The case of a patient with abdominal crisis and shock without any discernible origin who died 36 hours after hospital admission despite maximal therapy is described. Gram-negative sepsis, peritonitis and haemochromatosis with hepatic siderosis was the post-mortem diagnosis. We consider spontaneous peritonitis arising from translocation of normal intestinal flora (E. coli) through the intact wall of the gut combined with the impaired ability of the reticulo-endothelial system to remove endotoxin to be the causative factors. It is unknown whether the adrenal insufficiency due to siderophilic adrenal hypophysis and adrenal glands contributed to the fulminant course of the disease. Undiagnosed liver cirrhosis and especially haemochromatosis should therefore be included in the differential diagnostic considerations in patients presenting with these symptoms, and in whom no obvious cause for a septic focus can be found.
authors.affiliation: Zentrum für Anästhesiologie, Rettungs- und Intensivmedizin, Universität Göttingen.
authors.forename: M
authors.initials: M
authors.lastname: Sydow
authors.forename: T A
authors.initials: TA
authors.lastname: Crozier
authors.forename: A
authors.initials: A
authors.lastname: Schauer
authors.forename: H
authors.initials: H
authors.lastname: Burchardi
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000473:pathology; D004927:Escherichia coli Infections / Q000150:complications* / Q000473:pathology; D006432:Hemochromatosis / Q000150:complications* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D010179:Pancreas / Q000473:pathology; D012772:Shock, Septic / Q000209:etiology* / Q000473:pathology
vernacular_title: Septischer Schock mit akutem Abdomen bei idiopathischer Hämochromatose.