Nonocclusive mesenteric ischemia after aorto-iliac reconstruction of a ruptured abdominal aortic aneurysm: report of a case.
We report a case of nonocclusive mesenteric ischemia (NOMI), which developed after Y-grafting for a ruptured abdominal aortic aneurysm (AAA). A 71-year-old man was referred to our hospital with severe abdominal pain and signs of shock. Computed tomography revealed a ruptured AAA, and emergency aneurysmectomy and aortic grafting were performed. However, on postoperative day 7, a large amount of pus was seen oozing from the surgical wound. An emergency laparotomy revealed segmental, highly diffuse necrotic changes of the small intestine, but pulsation of the marginal artery in the necrotic region was palpable and blood flow was well audible by Doppler ultrasound. These findings were consistent with a diagnosis of NOMI.
Tsushimi
Takaaki
T
Department of Surgery, Yamaguchi Saiseikai General Hospital, 2-11 Midoricho, Yamaguchi,753-8517, Japan.
Furukawa
Shouichi
S
Gohra
Hidenori
H
Takahashi
Tsuyoshi
T
Fukuda
Shigetoshi
S
Oda
Tatsurou
T
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D007813:Laparotomy; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009336:Necrosis; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed