title: A case of an elderly patient with slowly progressive type 1 diabetes who developed severe nonocclusive mesenteric ischemia without predisposing events.
abstract: A 72-year-old woman with slowly progressive type 1 diabetes (SPIDDM) was admitted to our hospital because of increasing abdominal pain and diarrhea. The patient was diagnosed with nonocclusive mesenteric ischemia (NOMI), and a subtotal colonectomy was performed successfully. The resected sample revealed transmural gangrenous necrosis of the colon and rectum. This case is interesting because the severe NOMI occurred in a SPIDDM patient without common predisposing events such as hypoperfusion. Prolonged generation of reactive oxygen species in SPIDDM, together with the decline in adaptive response to oxidative stress with aging, might be an exacerbating factor for ischemic injury in the elderly.
authors.affiliation: Department of General Internal Medicine, Kobe University Hospital, Japan. harak@kobe-u.ac.jp
authors.forename: Kenta
authors.initials: K
authors.lastname: Hara
authors.forename: Hisafumi
authors.initials: H
authors.lastname: Yasuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Arai
authors.forename: Sonoko
authors.initials: S
authors.lastname: Miyoshi
authors.forename: Osamu
authors.initials: O
authors.lastname: Kubokawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mori
authors.forename: Taichi
authors.initials: T
authors.lastname: Akisaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kido
authors.forename: Koichi
authors.initials: K
authors.lastname: Yokono
authors.forename: Hozuka
authors.initials: H
authors.lastname: Akita
mesh_terms: D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis*; D065666:Mesenteric Ischemia; D012720:Severity of Illness Index; D014652:Vascular Diseases / Q000150:complications / Q000175:diagnosis*