title: Successful treatment of non-occlusive mesenteric ischemia (NOMI) using the HyperEye Medical System™ for intraoperative visualization of the mesenteric and bowel circulation: report of a case.
abstract: Non-occlusive mesenteric ischemia (NOMI), leading to intestinal gangrene without a demonstrable occlusion in the mesenteric artery, is a rare condition with extremely high mortality. We report a case of NOMI diagnosed preoperatively by computed tomography and treated successfully with surgery, assisted by indocyanine green (ICG) fluorescence in the HyperEye Medical System (HEMS), a new device that can simultaneously detect color and near-infrared rays under room light. This allowed for precise intraoperative evaluation of the mesenteric and bowel circulation. Although the necrotic bowel wall of the distal ileum and the segmental ischemia of the jejunum were visible, the jejunum was finally preserved because perfusion of ICG fluorescence was confirmed. The patient, an 84-year-old man, had an uneventful postoperative course and is alive without critical illness 8 months after surgery. We report this case to demonstrate the potential effectiveness of HEMS during surgery for NOMI.
authors: Department of Surgery, Mita Hospital, International Health and Welfare University, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan, nnitori@iuhw.ac.jp.
authors: Nobuhiro
authors: N
authors: Nitori
authors: Tomoaki
authors: T
authors: Deguchi
authors: Keisuke
authors: K
authors: Kubota
authors: Masashi
authors: M
authors: Yoshida
authors: Ayu
authors: A
authors: Kato
authors: Masayuki
authors: M
authors: Kojima
authors: Tomohisa
authors: T
authors: Kadomura
authors: Akihiro
authors: A
authors: Okada
authors: Juri
authors: J
authors: Okamura
authors: Michiya
authors: M
authors: Kobayashi
authors: Takayuki
authors: T
authors: Sato
authors: Yoshifumi
authors: Y
authors: Beck
authors: Yuko
authors: Y
authors: Kitagawa
authors: Masaki
authors: M
authors: Kitajima
mesh_terms: D000369:Aged, 80 and over; D001775:Blood Circulation; D005453:Fluorescence; D006801:Humans; D007082:Ileum / Q000098:blood supply; D007208:Indocyanine Green; D007432:Intraoperative Period; D007511:Ischemia / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007583:Jejunum / Q000098:blood supply; D008297:Male; D065666:Mesenteric Ischemia; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*
chemical_list: D007208:Indocyanine Green
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