title: Nonocclusive mesenteric ischemia: a lethal complication in peritoneal dialysis patients.
abstract: Nonocclusive mesenteric ischemia (NOMI) is a relatively uncommon disorder, seen primarily in elderly patients with cardiac disease, and is characterized by progressive intestinal ischemia leading to infarction, sepsis, and death. It is suspected of being the underlying cause in at least 20% - 30% of acute mesenteric ischemia patients. End-stage renal disease patients are among the highest risk populations for developing this lethal complication; however, NOMI is not unique to hemodialysis and can occur in peritoneal dialysis patients as well. Unfortunately, the presentation of NOMI is very similar to that of peritonitis. The key to correct diagnosis is a high index of suspicion in predisposed patients. The high mortality rate is a clear reflection of failure to recognize the syndrome at an earlier, treatable stage. We present our case experience and an extensive review of the literature regarding this dreadful complication that may be reversible if considered early as a possible etiology and the appropriate diagnostic maneuvers undertaken.
authors.affiliation: First Department of Propedeutic Surgery, Hippocration Hospital, University of Athens, Athens, Greece.
authors.forename: Fotios
authors.initials: F
authors.lastname: Archodovassilis
authors.forename: Emmanuel E
authors.initials: EE
authors.lastname: Lagoudiannakis
authors.forename: Dimitrios Konstantinos
authors.initials: DK
authors.lastname: Tsekouras
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Vlachos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Albanopoulos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Fillis
authors.forename: Andreas
authors.initials: A
authors.lastname: Manouras
authors.forename: John
authors.initials: J
authors.lastname: Bramis
mesh_terms: D000368:Aged; D003106:Colon / Q000098:blood supply*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D010531:Peritoneal Dialysis, Continuous Ambulatory