Eguchi Takashi, Koike Shoichiro, Maeno Kazuma, Nakamura Toshiyuki, Iwasa Takehiko, Nakazawa Koh, Furuta Kiyoshi
Department of Surgery, Matsumoto Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2007 Apr;104(4):555-60.
We report a case of nonocclusive mesenteric ischemia (NOMI) which occurred in a patient with torsion of gallbladder. A 91-year-old woman was admitted to the hospital and was diagnosed of acute cholecystitis. The next day, she went into shock. Then, we diagnosed her illness as torsion of gallbladder by computed tomography and ultrasonography, and performed an emergency operation. After cholecystectomy, it was recognized that the wide range of the small intestine had become necrotic sporadically. We diagnosed it as NOMI, and performed the wide resection of the small intestine followed by making double stomas. There is no previous report of NOMI associated with torsion of gallbladder. We guess the cause of NOMI in this case would be dehydration because of gallbladder torsion. NOMI has high mortality. Early diagnosis and early treatment are of great importance in NOMI.
我们报告一例发生在胆囊扭转患者中的非闭塞性肠系膜缺血（NOMI）病例。一名91岁女性入院，被诊断为急性胆囊炎。第二天，她出现休克。随后，我们通过计算机断层扫描和超声检查将她的病情诊断为胆囊扭转，并进行了急诊手术。胆囊切除术后，发现大范围的小肠散在性坏死。我们将其诊断为NOMI，并进行了小肠广泛切除及双造口术。此前尚无NOMI与胆囊扭转相关的报道。我们推测该病例中NOMI的病因是胆囊扭转导致的脱水。NOMI死亡率高。早期诊断和早期治疗对NOMI至关重要。
