A Successful Treatment for Myonephropathic Metabolic Syndrome and Delayed Intestinal Ischemia after Operation of Acute Type B Aortic Dissection with Bilateral Lower Limb Ischemia
10.4326/jjcvs.37.349
- VernacularTitle:術後 myonephropathic metabolic syndrome および腸管壊死を認めた Saddle block 型虚血合併急性 B 型大動脈解離の1治験例
- Author:
Hiroyuki Kurosawa
;
Hirono Satokawa
;
Yoichi Sato
;
Shinya Takase
;
Yukitoki Misawa
;
Hiroki Wakamatsu
;
Yuki Seto
;
Eitoshi Tsuboi
;
Kenichi Muramatsu
;
Hitoshi Yokoyama
- Publication Type:Journal Article
- Keywords:
MNMS
- From:Japanese Journal of Cardiovascular Surgery
2008;37(6):349-352
- CountryJapan
- Language:Japanese
-
Abstract:
A 20-year-old man suddenly complained of back pain and bilateral lower limb weakness. Computed tomography showed acute type B aortic dissection. The patent false lumen extended from distal arch to the left common iliac artery. The true lumen was severely compressed by the false lumen and both legs were ischemic. He underwent emergency fenestration of the abdominal aorta and stenting of the left iliac artery. Although the lower limbs ischemia was improved, he developed myonephropathic metabolic syndrome and received plasma exchange, continuous hemodialysis and endotoxin absorption therapy. Thirteen days after the operation, intestinal ischemia occurred and he underwent emergency bowel resection with creation of a stoma. Development of dissection to the superior mesenteric artery (SMA) and the malperfusion of SMA by severe compression of the true lumen were thought to cause intestinal ischemia.
