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Non-occlusive mesenteric ischemia localized in the transverse colon: a case report
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is ischemia of the mesentery that is caused by hypoperfusion or vasospasm without any thrombosis. NOMI is difficult to diagnose by physical examination alone. Although angiographic examination of the superior mesenteric artery (SMA) is the usual d...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5307407/ https://www.ncbi.nlm.nih.gov/pubmed/28188511 http://dx.doi.org/10.1186/s40792-017-0299-x |
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author | Murono, Koji Ishihara, Soichiro Kawai, Kazushige Kaneko, Manabu Sasaki, Kazuhito Yasuda, Koji Otani, Kensuke Nishikawa, Takeshi Tanaka, Toshiaki Kiyomatsu, Tomomichi Hata, Keisuke Nozawa, Hiroaki Hayashi, Akimasa Ushiku, Tetsuo Fukayama, Masashi Watanabe, Toshiaki |
author_facet | Murono, Koji Ishihara, Soichiro Kawai, Kazushige Kaneko, Manabu Sasaki, Kazuhito Yasuda, Koji Otani, Kensuke Nishikawa, Takeshi Tanaka, Toshiaki Kiyomatsu, Tomomichi Hata, Keisuke Nozawa, Hiroaki Hayashi, Akimasa Ushiku, Tetsuo Fukayama, Masashi Watanabe, Toshiaki |
author_sort | Murono, Koji |
collection | PubMed |
description | BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is ischemia of the mesentery that is caused by hypoperfusion or vasospasm without any thrombosis. NOMI is difficult to diagnose by physical examination alone. Although angiographic examination of the superior mesenteric artery (SMA) is the usual diagnostic method used, it is an invasive examination. Usually, a long range of the bowel becomes discontinuously necrotic in NOMI. Here, we report a rare case of NOMI localized in the transverse colon that was diagnosed by computed tomography (CT) angiography which is a minimally invasive examination. CASE PRESENTATION: A 72-year-old woman was referred to our hospital for further treatment of abdominal pain that developed 1 day before presentation. Contrast-enhanced abdominal CT scan revealed attenuated enhancement of the transverse colon. CT angiography showed SMA irregularities due to vasospasm. The middle colic artery could not be detected by CT angiography. No occlusion due to thrombus or embolism in the SMA and superior mesenteric vein was observed. Based on the findings, NOMI was suspected, and emergency laparotomy was performed, which revealed a segmentally necrotic transverse colon. The necrotic bowel was resected, and stomas were created. CONCLUSION: The presence of hypotension in the patient necessitated the use of CT angiography, which proved very useful in the early diagnosis of the present case. Thus, if intestinal ischemia is suspected, even in case of a short segment, CT angiography should be performed. |
format | Online Article Text |
id | pubmed-5307407 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-53074072017-02-28 Non-occlusive mesenteric ischemia localized in the transverse colon: a case report Murono, Koji Ishihara, Soichiro Kawai, Kazushige Kaneko, Manabu Sasaki, Kazuhito Yasuda, Koji Otani, Kensuke Nishikawa, Takeshi Tanaka, Toshiaki Kiyomatsu, Tomomichi Hata, Keisuke Nozawa, Hiroaki Hayashi, Akimasa Ushiku, Tetsuo Fukayama, Masashi Watanabe, Toshiaki Surg Case Rep Case Report BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is ischemia of the mesentery that is caused by hypoperfusion or vasospasm without any thrombosis. NOMI is difficult to diagnose by physical examination alone. Although angiographic examination of the superior mesenteric artery (SMA) is the usual diagnostic method used, it is an invasive examination. Usually, a long range of the bowel becomes discontinuously necrotic in NOMI. Here, we report a rare case of NOMI localized in the transverse colon that was diagnosed by computed tomography (CT) angiography which is a minimally invasive examination. CASE PRESENTATION: A 72-year-old woman was referred to our hospital for further treatment of abdominal pain that developed 1 day before presentation. Contrast-enhanced abdominal CT scan revealed attenuated enhancement of the transverse colon. CT angiography showed SMA irregularities due to vasospasm. The middle colic artery could not be detected by CT angiography. No occlusion due to thrombus or embolism in the SMA and superior mesenteric vein was observed. Based on the findings, NOMI was suspected, and emergency laparotomy was performed, which revealed a segmentally necrotic transverse colon. The necrotic bowel was resected, and stomas were created. CONCLUSION: The presence of hypotension in the patient necessitated the use of CT angiography, which proved very useful in the early diagnosis of the present case. Thus, if intestinal ischemia is suspected, even in case of a short segment, CT angiography should be performed. Springer Berlin Heidelberg 2017-02-10 /pmc/articles/PMC5307407/ /pubmed/28188511 http://dx.doi.org/10.1186/s40792-017-0299-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Case Report Murono, Koji Ishihara, Soichiro Kawai, Kazushige Kaneko, Manabu Sasaki, Kazuhito Yasuda, Koji Otani, Kensuke Nishikawa, Takeshi Tanaka, Toshiaki Kiyomatsu, Tomomichi Hata, Keisuke Nozawa, Hiroaki Hayashi, Akimasa Ushiku, Tetsuo Fukayama, Masashi Watanabe, Toshiaki Non-occlusive mesenteric ischemia localized in the transverse colon: a case report |
title | Non-occlusive mesenteric ischemia localized in the transverse colon: a case report |
title_full | Non-occlusive mesenteric ischemia localized in the transverse colon: a case report |
title_fullStr | Non-occlusive mesenteric ischemia localized in the transverse colon: a case report |
title_full_unstemmed | Non-occlusive mesenteric ischemia localized in the transverse colon: a case report |
title_short | Non-occlusive mesenteric ischemia localized in the transverse colon: a case report |
title_sort | non-occlusive mesenteric ischemia localized in the transverse colon: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5307407/ https://www.ncbi.nlm.nih.gov/pubmed/28188511 http://dx.doi.org/10.1186/s40792-017-0299-x |
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