Necrotic colitis in the presence of normal vascularization of the colon.

Necrotic colitis in the absence of organic obstruction of the mesenteric vessels is an extreme and fulminant form of ischemic colitis. This calamity with its high mortality rate usually occurs in patients with pre-existent cardiopathy. It is rare for necrotic colitis to occur as a complication of hypotension, hypovolemia or sepsis. A report is presented of a case of total gangrene of the colon in a patient with hemorrhagic shock. Certain concepts are presented concerning the etiology of non-occlusive intestinal infarction. It is postulated that the fulminant gangrene of the colon is co-induced by Gram-positive rods which are demonstrable even in the deep layers of the colonic wall.