Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental Disability

Background. Nonocclusive mesenteric ischemia (NOMI) defines acute mesenteric ischemia without occlusion of the mesenteric arteries. The most common cause of NOMI is vasoconstriction or vasospasm of a mesenteric artery. NOMI generally affects patients >50 years of age, and few cases have been repo...

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Main Authors: Manami Mizumoto, Fumihiro Ochi, Toshihiro Jogamoto, Kentaro Okamoto, Mitsumasa Fukuda, Toshifumi Yamauchi, Toyohisa Miyata, Ryo Tashiro, Mariko Eguchi, Riko Kitazawa, Eiichi Ishii
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2019/5354074
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author Manami Mizumoto
Fumihiro Ochi
Toshihiro Jogamoto
Kentaro Okamoto
Mitsumasa Fukuda
Toshifumi Yamauchi
Toyohisa Miyata
Ryo Tashiro
Mariko Eguchi
Riko Kitazawa
Eiichi Ishii
author_facet Manami Mizumoto
Fumihiro Ochi
Toshihiro Jogamoto
Kentaro Okamoto
Mitsumasa Fukuda
Toshifumi Yamauchi
Toyohisa Miyata
Ryo Tashiro
Mariko Eguchi
Riko Kitazawa
Eiichi Ishii
author_sort Manami Mizumoto
collection DOAJ
description Background. Nonocclusive mesenteric ischemia (NOMI) defines acute mesenteric ischemia without occlusion of the mesenteric arteries. The most common cause of NOMI is vasoconstriction or vasospasm of a mesenteric artery. NOMI generally affects patients >50 years of age, and few cases have been reported in children. Case Presentation. A 15-year-old boy with severe neurodevelopmental disability developed sudden-onset fever, abdominal distention, and dyspnea. Laboratory and radiological findings indicated acute intestinal obstruction and prerenal failure. He developed transient cardiopulmonary arrest and hypovolemic shock. Emergent laparotomy was performed, which revealed segmentally necrotic intestine from the jejunum to the ascending colon with pulsation of peripheral intestinal arteries, leading to a diagnosis of NOMI. The necrotic intestine was resected, and stomas were created. He was discharged on postoperative day 334 with short bowel syndrome as a complication. Conclusions. NOMI should be considered a differential diagnosis for intestinal symptoms with severe general conditions in both adults and children with underlying disease. Immediate surgical exploration is essential with NOMI to save a patient’s life.
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spelling doaj-art-b51266a35db64db0be0d7d0de16713672025-08-20T02:23:30ZengWileyCase Reports in Pediatrics2090-68032090-68112019-01-01201910.1155/2019/53540745354074Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental DisabilityManami Mizumoto0Fumihiro Ochi1Toshihiro Jogamoto2Kentaro Okamoto3Mitsumasa Fukuda4Toshifumi Yamauchi5Toyohisa Miyata6Ryo Tashiro7Mariko Eguchi8Riko Kitazawa9Eiichi Ishii10Department of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDivision of Diagnostic Pathology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanDepartment of Pediatrics, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, JapanBackground. Nonocclusive mesenteric ischemia (NOMI) defines acute mesenteric ischemia without occlusion of the mesenteric arteries. The most common cause of NOMI is vasoconstriction or vasospasm of a mesenteric artery. NOMI generally affects patients >50 years of age, and few cases have been reported in children. Case Presentation. A 15-year-old boy with severe neurodevelopmental disability developed sudden-onset fever, abdominal distention, and dyspnea. Laboratory and radiological findings indicated acute intestinal obstruction and prerenal failure. He developed transient cardiopulmonary arrest and hypovolemic shock. Emergent laparotomy was performed, which revealed segmentally necrotic intestine from the jejunum to the ascending colon with pulsation of peripheral intestinal arteries, leading to a diagnosis of NOMI. The necrotic intestine was resected, and stomas were created. He was discharged on postoperative day 334 with short bowel syndrome as a complication. Conclusions. NOMI should be considered a differential diagnosis for intestinal symptoms with severe general conditions in both adults and children with underlying disease. Immediate surgical exploration is essential with NOMI to save a patient’s life.http://dx.doi.org/10.1155/2019/5354074
spellingShingle Manami Mizumoto
Fumihiro Ochi
Toshihiro Jogamoto
Kentaro Okamoto
Mitsumasa Fukuda
Toshifumi Yamauchi
Toyohisa Miyata
Ryo Tashiro
Mariko Eguchi
Riko Kitazawa
Eiichi Ishii
Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental Disability
Case Reports in Pediatrics
title Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental Disability
title_full Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental Disability
title_fullStr Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental Disability
title_full_unstemmed Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental Disability
title_short Nonocclusive Mesenteric Ischemia Rescued by Immediate Surgical Exploration in a Boy with Severe Neurodevelopmental Disability
title_sort nonocclusive mesenteric ischemia rescued by immediate surgical exploration in a boy with severe neurodevelopmental disability
url http://dx.doi.org/10.1155/2019/5354074
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