Postoperative Progress of a Patient Who Underwent Massive Small Intestine Resection for NOMI after AVR
10.4326/jjcvs.42.42
- VernacularTitle:大動脈弁置換術後の非閉塞性腸管虚血（NOMI : nonocclusive mesenteric ischemia）に対して小腸大量切除を行った1治験例とその術後経過
- Author:
Hiromichi Fujii
;
Takanobu Aoyama
;
Katsuaki Hige
;
Yoshikado Sasako
- Publication Type:Journal Article
- Keywords:
cardiac surgery;
NOMI;
short bowel syndrome;
postoperative progress
- From:Japanese Journal of Cardiovascular Surgery
2013;42(1):42-45
- CountryJapan
- Language:Japanese
-
Abstract:
Nonocclusive mesenteric ischemia (NOMI) after cardiac surgery is a rare and fatal complication. Although there are a few reports of successful treatment of NOMI, progress after treatment is not known. This case report describes the postoperative course of a 79-year-old male patient who underwent successful treatment of NOMI after aortic valve replacement (AVR). Plain abdominal computed tomography revealed gas in the small intestinal wall 14 days after AVR. Emergency massive small bowel resection was performed because wide and discontinuous necrotic changes of the small intestine were confirmed. Although the patient temporarily returned to normal life after discharge, sepsis due to urinary tract infection or acute cholecystitis and central venous route infection occurred repeatedly. The patient was intermittently admitted for a total of 14 of 25 months after the first discharge. The patient died of sepsis due to Candida infection and liver failure 52 months after AVR. Even if treatment for NOMI is successful, there is an unfavorable prognosis in terms of immunity and nutrition for short bowel syndrome. Because there are no symptoms or laboratory data specific to NOMI, it is considered important to immediately and adequately diagnose and treat NOMI without overlooking abnormalities after cardiac surgery.
