Fatal bacterial peritonitis secondary to nonobstructive colonic dilatation (Ogilvie's syndrome) in cirrhotic ascites.

A cirrhotic woman developed pneumococcal pneumonia with sepsis. Antibiotic therapy initially resulted in defervescence. However, nonobstructive colonic dilatation developed along with fever and clinical deterioration. Abdominal paracentesis and blood cultures revealed Escherichia coli bacterial peritonitis and bacteremia. The patient died. Autopsy revealed massive cecal mucosal ulceration, which was interpreted as the cause of the bacterial peritonitis.