[Nonobstructive mesenteric ischemia--a diagnostic problem in internal intensive care].
Four cases of acute gut ischemia in elderly patients due to non-occlusive disease (NOD) are presented. Bowel necrosis occurred after episodes of hypotension in the course of myocardial infarction, arrhythmias and sepsis. Symptoms and clinical findings were blurred by the underlying extraintestinal disease. Angiography showed coexistent atherosclerosis but no occlusion of the major celiac and mesenteric vessels. At laparotomy (three cases) or autopsy (one case) extensive small and large bowel necroses were detected. Early laparotomy (possibly preceded by laparoscopy) is recommended for patients with suspected acute gut ischemia even if angiography fails to reveal occlusion of the large splanchnic arteries.
Scheppach
W
W
Medizinische Klinik, Universität Würzburg.
Langenfeld
H
H
Schultz
G
G
Wittenberg
G
G
Hahn
D
D
Kochsiek
K
K
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007022:Hypotension / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008638:Mesenteric Arteries / Q000473:pathology; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D012772:Shock, Septic / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology
Nicht-okklusive Mesenterialischämie--ein diagnostisches Problem der internistischen Intensivmedizin.