Dhoble Abhijeet, Patel Kamakshi, Khasnis Atul
Department of Internal Medicine, Michigan State University, East Lansing, Michigan, USA.
Cases J. 2008 Jul 25;1(1):60. doi: 10.1186/1757-1626-1-60.
Non-occlusive mesenteric ischemia (NOMI) is not uncommon in intensive care units. NOMI indicate ischemia of bowel wall without any significant obstruction in the mesenteric arteries. Common causes of NOMI include sepsis, severe cardiac failure, and any critical illness. Mesenteric circulation can suffer due to low cardiac output leading to very unfortunate outcomes. Pneumatosis Intestinalis is a radiologic sign which represent gas in the bowel wall, and could indicate mesenteric ischemia.
We present a fatal case of a patient who developed NOMI secondary to multiple factors. Patient died after a long protracted course in the hospital secondary to severe septic shock.
This case emphasizes the importance of early detection and management of NOMI in a patient with low cardiac output and abdominal pain. In majority of the studies, NOMI is associated with high morbidity and mortality.
非闭塞性肠系膜缺血（NOMI）在重症监护病房并不罕见。NOMI指肠壁缺血，而肠系膜动脉无任何明显梗阻。NOMI的常见病因包括脓毒症、严重心力衰竭及任何危重病。由于心输出量低，肠系膜循环会受到影响，导致非常不幸的后果。肠壁积气是一种放射学征象，代表肠壁内有气体，可能提示肠系膜缺血。
我们报告一例因多种因素继发NOMI的致命病例。患者在医院经过漫长病程后，因严重感染性休克死亡。
该病例强调了对心输出量低且腹痛患者早期检测和处理NOMI的重要性。在大多数研究中，NOMI与高发病率和死亡率相关。
