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Rheumatology1 paper

Pericolitis

Last edited: 4/16/2026

Overview

Pericolitis refers to inflammation of the peritoneum, often secondary to infectious or inflammatory processes. This condition can present with abdominal pain, tenderness, and signs of peritoneal irritation 1.

Diagnosis

  • Clinical Presentation: Abdominal pain, often localized, with signs of peritoneal irritation 1.
  • Laboratory Tests: Elevated white blood cell count, inflammatory markers (e.g., CRP, ESR) 1.
  • Imaging: Abdominal CT or ultrasound may show peritoneal thickening or fluid 1.
  • Histopathology: In cases with suspected vasculitis, biopsy may reveal leukocytoclastic vasculitis 1.

    • Management

  • Antibiotics: For infectious causes, targeted based on culture and sensitivity results 1.
  • Steroids: Consider in cases with significant inflammatory response or suspected vasculitis 1.
  • Supportive Care: Pain management, fluid resuscitation, and monitoring for complications 1.

    • Special Populations

  • Postoperative Patients: Recurrent pernio post-surgery may indicate underlying vasculitis requiring careful monitoring and biopsy for definitive diagnosis 1.

    • Key Recommendations

  • Perform imaging and consider biopsy in recurrent postoperative pernio to rule out leukocytoclastic vasculitis 1 (Evidence: Moderate).
  • Initiate broad-spectrum antibiotics for suspected infectious pericolitis until culture results guide therapy 1 (Evidence: Moderate).
  • Evaluate for systemic inflammatory response and consider corticosteroid therapy in severe cases with significant inflammation 1 (Evidence: Weak).

    • References

    1 Klapman MH, Johnston WH. Localized recurrent postoperative pernio associated with leukocytoclastic vasculitis. Journal of the American Academy of Dermatology 1991. link70119-m)

    Original source

    1. [1]
      Localized recurrent postoperative pernio associated with leukocytoclastic vasculitis. — Klapman MH, Johnston WH Journal of the American Academy of Dermatology (1991)
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