Septic shock associated with operations for colorectal disease

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Abstract
The hospital records of 24 patients with septic shock associated with the need for surgical treatment of diseases of the colon and rectum were reviewed. Shock was caused by gram-negative or anaerobic bacteria. The sources of infection were the abdomen, chest, and urinary tract. Nineteen (79%) patients survived the acute shock episode, but only 4 (16%) were permanent survivors. The 15 patients who died following resuscitation from shock succumbed to continuing infection and/or multiple organ failure. Although the timing of treatment did not affect immediate survival, long-term survival occurred only among those patients treated early in the course of shock. Pathophysiology of early septic shock is presented and the need to recognize and treat the condition at this stage is emphasized. A current treatment protocol, which is reported to achieve 85% acute and 60% long-term survival, is discussed.