Sepsis like a severe complication of autoimmune liver disease in gastroenterological patients

Abstract

In article we present particular qualities of disease pattern and methods of treatment in patients with ulcer colitis associated with primary sclerosing cholangitis and autoimmune hepatitis. Course of disease was complicated by bacterial cholangitis, sepsis, multiple organ failure. There are described pathogenetic features of autoimmune livers and bowel illness. It was shown the role of bacterial translocation of microbes. There are described about differential diagnostic of primary and secondary cholangitis. Features of curing the patients are reminded in critical conditions are reviewed in article. There sketched role of glucocorticosteroids in critical care. Modern guidelines for the management the patients with overlap syndrome are highlighted. Patient D. was admitted to hospital in intensive care unit. There disease patterns of collapse, systemic inflammation response syndrome. The examination was established exacerbation of ulcer colitis complicated inflectional morbidity with sclerosing cholangitis and autoimmune hepatitis. This condition led to sepsis and multiple organ failure. Instead of intensive care there was a progressive deterioration until near death experience. Resuscitation procedure within 6 minutes were successful. Multiple areas of necrosis have developed on the limbs because of multiple organ failure and intensive vasopressors therapy. Glucocorticosteroids were prescribed in combination with antibacterial drugs were assigned because of ulcerative colitis’s exacerbation and cytolysis, regardless sepsis. On the thirtieth day of stay in hospital, the patient D. was transferred from the intensive care unit to the gastroenterology department, where the treatment was continued. Because of the cure signs of multiple organ failure, infectious complications, exacerbation of ulcerative colitis and primary sclerosing cholangitis were regressed. We supervise of patient.