Department of Medicine, National Hospital Organization Higashi-ohmi General Medical Center, Japan.
Department of Surgery, National Hospital Organization Higashi-ohmi General Medical Center, Japan.
Intern Med. 2023 Mar 1;62(5):729-732. doi: 10.2169/internalmedicine.0074-22. Epub 2022 Jul 29.
An 86-year-old Japanese woman was referred to our hospital due to the sudden onset of abdominal pain. Abdominal contrast-enhanced computed tomography (CT) revealed no signs of ischemic bowel; however, laboratory investigations revealed metabolic lactic acidosis, elevation of inflammatory markers, and a remarkable elevation in the serum phosphate level. A prompt surgical evaluation revealed non-occlusive mesenteric ischemia (NOMI). Elevated serum phosphate levels may suggest extensive bowel ischemia or infarction, which can lead to a prompt surgical evaluation, even in the absence of specific radiological findings.
一位 86 岁的日本女性因突发腹痛被转至我院。腹部增强 CT 未见缺血性肠病的征象；然而，实验室检查显示代谢性乳酸性酸中毒、炎症标志物升高和血清磷酸盐水平显著升高。及时的外科评估显示非闭塞性肠系膜缺血（NOMI）。血清磷酸盐水平升高可能提示广泛的肠缺血或梗死，即使没有特定的影像学发现，也应及时进行外科评估。
