Septic shock associated with operations for colorectal disease.

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. In this group of patients shock was caused by gram-negative or anaerobic microorganisms. The sources or infection were the abdomen, chest, and urinary tract. Nineteen (79 per cent) patients survived the acute shock episode, but only four (16 per cent) 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. Accordingly, the pathophysiology of early septic shock is presented, and the need to recognize and treat the condition at this stage is emphasized. In addition, the author's current treatment protocol, with which they have been able to achieve 85 per cent acute and 60 per cent long-term survival, is discussed.