A Case of Acute Inferior Mesenteric Artery Occulusion.

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  • 急性下腸間膜動脈閉塞症の１例

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Abstract

An 82-year-old man undergoing hemodialysis for chronic renal failure was admitted to the hospital because of epigastralgia, vomiting and fever after a hemodialysis. On the following day, he had left lower abdominal pain and hard abdomen. Laboratory data showed abnormal findings. Abdominal plain CT scan showed dilation of the small intestine and calcification of the aorta, superior mesenteric artery and inferior mesenteric artery. We suspected panperitonitis due to perforation of the large intestine or mesenteric artery occulusion. He had already been in shock before surgery. At laparotomy, intestinal necrosis was present in the region of inferior mesenteric artery, and the inferior mesenteric artery was pulseless. Acute inferior mesenteric artery occulusion was diagnosed. Left hemicolectomy and a colostomy were conducted. Endotoxin absorption therapy and continuous hemodiafiltration were started after the operation, but he belonged to multiple organ failure and died on the second postoperative day.<br> In Japan only 10 cases have been reported including this case since 1985. We report this rare disease.

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