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A Study of the Diagnosis and Treatment of Nonocclusive Mesenteric Ischemia (NOMI) with Special Reference to the Effectiveness of Arterial Infusion Therapy
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- Kataoka Yuichi
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
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- Shimada Ken
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
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- Kashimi Fumie
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
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- Kanoh Tomomichi
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
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- Hanajima Tasuku
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
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- Woodhams Reiko
- Department of Diagnositic Radiology, Kitasato University School of Medicine
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- Soma Kazui
- Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
Bibliographic Information
- Other Title
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- NOMI(non-occlusive mesenteric ischemia)の診断と治療法に関する検討─特に動注療法の有用性について─
Description
At our hospital, 17 patients with NOMI have been treated in the past 6 years; of these, 5 (29%) died in hospital. Angiography was proactively performed when NOMI was suspected on the basis of clinical findings and CT. Arterial infusion therapy was performed in 13 patients: 2 patients improved without surgery; 3 patients underwent laparotomy but intestinal resection was avoided; and for 1 patient the extent of resection was reduced during second-look surgery. Arterial infusion therapy comprised continuous intra-arterial administration of papaverine following bolus administration of prostaglandin E1 via a catheter placed in the superior mesenteric artery. If persistent peritoneal signs were evident, surgery was performed. Surgery was carried out in 12 patients. Mortality among the 8 patients who underwent both arterial infusion therapy and laparotomy was 25%. Patients who died had already developed multiple organ failure when treatment was started, as it had taken time for the diagnosis to be made. Early diagnosis and arterial infusion therapy on the assumption of surgery should contribute to improving therapeutic outcomes.
Journal
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- Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)
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Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) 31 (7), 1015-1019, 2011
Japanese Society for Abdominal Emergency Medicine
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Keywords
Details 詳細情報について
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- CRID
- 1390001204734228096
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- NII Article ID
- 130004508953
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- ISSN
- 18824781
- 13402242
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- Text Lang
- ja
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- Data Source
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- JaLC
- CiNii Articles
- Crossref
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- Abstract License Flag
- Disallowed
