title: Non-occlusive mesenteric ischemia after splenic metastasectomy for small-cell lung cancer.
abstract: A 68-year-old man presented with severe abdominal pain. Seven months earlier, he had received systemic chemotherapy for small-cell lung cancer with solitary metastasis to the spleen, followed by splenectomy. Abdominal computed tomography and abdominal arterial angiography showed diffuse ischemia of the mesenteric artery without apparent occlusion. The patient also suffered from septicemia caused by Enterococcus faecium. Therefore, a diagnosis of non-occlusive mesenteric ischemia (NOMI) induced by septicemia was supposed. Although treatment with antibiotics and papaverine hydrochloride was administered and the necrotic tissue in the intestinal tract was resected, the patient died. Physicians should be aware that patients undergoing splenectomy are likely to be affected by septicemia, which may subsequently induce NOMI.
authors.affiliation: Department of General Internal Medicine 4, Kawasaki Medical School, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Yamane
authors.forename: Naoki
authors.initials: N
authors.lastname: Fukuda
authors.forename: Ken
authors.initials: K
authors.lastname: Nishino
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshida
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Ochi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yamagishi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Honda
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Monobe
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Mimura
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naomoto
authors.forename: Nagio
authors.initials: N
authors.lastname: Takigawa
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D044466:Asian People; D017809:Fatal Outcome; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000150:complications / Q000473:pathology; D008297:Male; D008638:Mesenteric Arteries / Q000503:physiopathology; D065666:Mesenteric Ischemia / Q000188:drug therapy / Q000209:etiology*; D059146:Metastasectomy / Q000009:adverse effects*; D010208:Papaverine / Q000627:therapeutic use; D016491:Peripheral Vascular Diseases / Q000150:complications; D018805:Sepsis / Q000209:etiology; D055752:Small Cell Lung Carcinoma / Q000556:secondary* / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects*; D013160:Splenic Neoplasms / Q000150:complications / Q000556:secondary* / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D010208:Papaverine