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Surgery for acute exacerbation of chronic mesenteric ischemia : a case report
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| Title: | Surgery for acute exacerbation of chronic mesenteric ischemia : a case report |
| Authors: | Abe, Shinji Browse this author | | Yamakawa, Tomoji Browse this author | | Kawashima, Hideaki Browse this author | | Yoshida, Makoto Browse this author | | Takanashi, Setsuji Browse this author | | Kashiyama, Motoya Browse this author | | Ishigooka, Masahiro Browse this author | | Shingu, Yasushige Browse this author | | Matsui, Yoshiro Browse this author →KAKEN DB |
| Keywords: | Chronic mesenteric ischemia | | Surgical revascularization |
| Issue Date: | 5-Dec-2016 |
| Publisher: | Springer |
| Journal Title: | Surgical case reports |
| Volume: | 2 |
| Start Page: | 146 |
| Publisher DOI: | 10.1186/s40792-016-0272-0 |
| Abstract: | Background: Chronic mesenteric ischemia (CMI) is a rare disease; however, symptomatic CMI has a risk of acute exacerbation without timely revascularization. Case presentation: A 54-year-old man who had had postprandial pain for 6 months was admitted to our hospital because of vomiting and diarrhea. Although the celiac and superior mesenteric arteries were occluded at the proximal portion, contrast enhancement of the bowel wall was good in contrast-enhanced computed tomography (CECT). Endoscopic examination revealed only a healed gastric ulcer and slight mucosal erosions in the colon. He was diagnosed as having acute enteritis or inflammatory digestive disease and observed with conservative therapy, which improved his acute symptoms. On hospitalization day 42, he suddenly complained of lower back pain. CECT showed abdominal free air, which indicated gastrointestinal perforation. Emergency surgery was performed for jejunum resection. Two days later, a second operation was performed for a leak in the anastomotic site of the jejunum. Necrotic change in the small intestinal serosa was also observed and required broad resection of the small intestine. He was diagnosed with acute exacerbation of CMI, and we performed surgical retrograde bypass to the gastroduodenal artery using a saphenous vein graft as the third operation. After the surgery, he was free from digestive symptoms and was discharged. Conclusions: When patients complain of chronic and gradual digestive symptoms, we should always consider symptomatic CMI. Timely mesenteric revascularization is important for symptomatic CMI before severe complications occur. |
| Rights: | https://creativecommons.org/licenses/by/4.0/ |
| Type: | article |
| URI: | http://hdl.handle.net/2115/64473 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 松居 喜郎
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