| Theme | Gastrointestinal Disease Due to Blood Flow Damage | |
|---|---|---|
| Title | Non-occlusive Mesenteric Ischemia | |
| Publish Date | 2019/01 | |
| Author | Katsunobu Teshigahara | Advanced Tertiary Emergency Medical Center, Saitama Red Cross Hospital |
| Author | Hiroyuki Kawaura | Advanced Tertiary Emergency Medical Center, Saitama Red Cross Hospital |
| Author | Masashi Gokita | Advanced Tertiary Emergency Medical Center, Saitama Red Cross Hospital |
| Author | Kazuya Kiyota | Advanced Tertiary Emergency Medical Center, Saitama Red Cross Hospital |
| Author | Akira Oki | Department of Surgery, Saitama Red Cross Hospital |
| [ Summary ] | Non-occlusive mesenteric ischemia (NOMI) shows a poor prognosis with a high mortality rate. The early symptoms and characteristics of NOMI are unclear; thus, diagnosis of NOMI is challenging. Delayed diagnosis leads to intestinal necrosis. Therefore, early diagnosis and prompt treatment are important to improve the survival rate in patients with NOMI. To date, an optimal therapeutic strategy has not been established for NOMI. Our strategy to treat patients with NOMI involves an emergency laparotomy with resection of necrotic bowel segments. This is followed by aggressive re-exploration (second-look operation) and delayed intestinal anastomosis in patients who develop intestinal necrosis. Subsequently, we perform postoperative intra-arterial infusions of papaverine (vasodilation therapy) if possible. |
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