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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| Format: | Article |
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Wiley
2019-01-01
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| 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. |
| format | Article |
| id | doaj-art-b51266a35db64db0be0d7d0de1671367 |
| institution | OA Journals |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| 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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