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August 1963

Viral Hepatitis Associated With Enteritis Gravis

Author Affiliations


Resident in Medicine (temporary), Maimonides Hospital, present address: Surgeon, US Public Health Service Indian Hospital, Phoenix, Ariz (Dr. Kravetz); Assistant Pathologist, Maimonides Hospital (Dr. Brazenas).

From the Departments of Medicine and Pathology, Maimonides Hospital of Brooklyn.

Arch Intern Med. 1963;112(2):179-183. doi:10.1001/archinte.1963.03860020077009

Little has been written about the gastrointestinal changes in viral hepatitis aside from the esophageal varices complicating postnecrotic cirrhosis. One review of 125 cases of "epidemic" hepatitis described 15% of the cases as having a phlegmonous inflammation of the gastrointestinal tract.1 Sherlock 2 described hemorrhages of the lung, intestines, heart, and kidneys in fatal hepatitis but is not more specific. Acute diffuse hemorrhagic necrosis of the bowel associated with viral hepatitis has not been previously reported. The anatomical findings are those of a distinct clinical and pathological entity first described in Germany by Jeckeln 3 in 1947; he called it Darmbrand (fire in the bowel). Enteritis gravis or necroticans is the more familiar name.

Report of a Case  A 66-year-old white housewife entered Maimonides Hospital on Feb 18, 1961, because of severe abdominal pain and diarrhea. There was an eight-week history of anorexia, nausea, vomiting, progressive weakness, jaundice, and weight