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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
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.
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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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