Successful Management of Non-Occlusive Mesenteric Ischemia (Nomi) - Case Report

• Authors: Guenter Weiss , Hans Lippert , Frank Meyer
• Languages of publication: EN

Abstracts

EN

Patients with non-occlusive mesenteric ischemia (NOMI) are still confronted with high mortality. The diagnostic is challenging and difficult because of the unspecific symptomatology. The aim of this systematic scientific report on an extraordinary and uncommon single clinical case and its successful course was to demonstrate the great potential of a partially novel non-surgical approach including its periinterventional management.A 73-year old female is precisely described, who developed an acute abdomen during the postoperative course after cardiosurgical intervention. Only explorative laparotomy clarified the correct diagnosis - NOMI. Despite general intensive care, patient developed multi-organ failure after this second intervention. Using consequently an image-guided minimally invasive radiological approach comprising the introduction of a catheter into the superior mesenteric artery (Seldinger's technique) and the continuous application of vasodilating medication such as alprostadil (prostaglandin) through this catheter enabled us to improve mesenteric perfusion effectively and to overcome multiorgan failure.In conclusion, specific risk factors may help to focus on the suspicion of NOMI. Diagnostic of choice is the arterial mesentericography, which allows specifically to exclude vascular occlusion including the consequence of a prompt surgical approach. Simultaneously, using the setting of the mesenteric angiography catheter can be placed for initiation of regional vasodilating treatment in case of NOMI. Only this approach may avoid fatal outcome.

Keywords

EN

non-occlusive mesenteric ischemia; mesentericography; intraarterial perfusion catheter; vasodilating treatment

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 4
• Pages: 214-218

Dates

published

1 - 4 - 2012

online

14 - 6 - 2012

Contributors

author

Guenter Weiss

• Intensive Care Unit, Department of General, Abdominal, Vascular Surgery University Hospital, Magdeburg, Germany

author

Hans Lippert

• Intensive Care Unit, Department of General, Abdominal, Vascular Surgery University Hospital, Magdeburg, Germany

author

Frank Meyer

• Intensive Care Unit, Department of General, Abdominal, Vascular Surgery University Hospital, Magdeburg, Germany

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Identifiers

DOI

10.2478/v10035-012-0035-y