A Patient with Severe Peritonitis due to Lower Intestinal Perforation Successfully Treated by Combination Therapy of Endotoxin Elimination (PMX)/Continuous Hemofiltration

Abstract

A 75-year-old woman was admitted to our hospital on 8th March 2001 with severe abdominal peritonitis due to rectal perforation. We operated urgently with a rectal resection and a permanent colostomy. The patient was developing septic shock, so we administered substantial doses of dopamine and noreninephrine for her poor blood circulation. We performed endotoxin elimination (PMX) and continuous hemofiltration (CHF) for her sepsis. The dosage of norepinephrine was maintained, and enabled control of the patient's blood pressure, urine volume and systemic edema. We conclude that PMX and CHF therapy is effective to improve the hemodynamic state following cardiac failure due to lower intestinal perforation.