Bacterial peritonitis occurring after recovery from severe accidental hypothermia.

DOI 12 References
  • Tsushima Kenji
    Department of Internal Medicine and Cardiology, Nagano Red Cross Hospital
  • Koyama Shigeru
    Department of Internal Medicine and Cardiology, Nagano Red Cross Hospital
  • Chino Masaaki
    Department of Internal Medicine and Cardiology, Nagano Red Cross Hospital
  • Akahane Kunio
    Department of Internal Medicine and Cardiology, Nagano Red Cross Hospital
  • Ichiyoshi Takeo
    Department of Internal Medicine and Cardiology, Nagano Red Cross Hospital

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  • 偶発性高度低体温症改善後に生じた細菌性腹膜炎にて死亡した１例

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We present the case of a patient who suffered accidental hypothermia. The patient's rectal temperature was 25°C on arrival. She showed disturbance of consciousness (JCS III-200) and circulatory shock due to the hypothermia. We attempted treatment by intravenous administration of heated fluids and irrigation of the stomach with warm physiological saline. Although within the next 12 hours her body temperature gradually normalized, she suffered multiple organ failure and developed bacterial peritonitis. She died of adult respiratory distress syndrome, bacterial peritonitis and sepsis caused by Pseudomonas aeruginosa. Prolonged hypothermia accelerated coagulatory system due to hypotension, dehydoration, microscopic circulatory failure, acceleration of blood viscosity and disseminated intravascular coagulation. Several techniques of active core rewarming are reported. Rapid rewarming is the most important of all to prevent thrombosis. Therefore for the non-arrested patient who has a temperature less than 30°C, extracorporeal circulation seems to be the technique of choice, for the arrested patient without trauma, cardiopulmonary bypass seems to be the technique. These treatments prevent complications after recovery from hypothermia.

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