Kuribayashi Nobuyuki, Tokuzen Norihiko, Goda Hiroyuki, Hino Satoshi, Uchida Daisuke
Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, JPN.
Cureus. 2024 Mar 29;16(3):e57229. doi: 10.7759/cureus.57229. eCollection 2024 Mar.
Nonocclusive mesenteric ischemia (NOMI) causes mesenteric ischemia and intestinal necrosis despite the absence of organic obstruction, such as thrombi and emboli in mesenteric blood vessels, and it has an extremely poor prognosis. We report a case of NOMI developed during bioradiotherapy (BRT) with cetuximab for cervical lymph node metastasis of tongue cancer. The patient was a 73-year-old man who underwent right radical neck dissection for neck lymph node metastasis after tongue cancer surgery. Postoperatively, the patient received BRT with cetuximab. On the 34th day after BRT, the patient had abdominal distension and a decreased level of consciousness. Contrast-enhanced computed tomography revealed mesenteric ischemia without thrombi and extensive intestinal emphysema. The patient was diagnosed with NOMI. Furthermore, he had septic shock and was treated with vasopressors and antibacterial agents; however, the condition of the patient did not improve, and he died on the same day.
非闭塞性肠系膜缺血(NOMI)即使在没有诸如肠系膜血管中的血栓和栓子等器质性梗阻的情况下也会导致肠系膜缺血和肠坏死,并且其预后极差。我们报告一例在使用西妥昔单抗进行生物放疗(BRT)治疗舌癌颈部淋巴结转移期间发生的NOMI病例。该患者为一名73岁男性,在舌癌手术后因颈部淋巴结转移接受了右颈根治性淋巴结清扫术。术后,患者接受了西妥昔单抗BRT治疗。BRT治疗后第34天,患者出现腹胀和意识水平下降。增强计算机断层扫描显示肠系膜缺血但无血栓形成以及广泛的肠气肿。该患者被诊断为NOMI。此外,他发生了感染性休克,并接受了血管升压药和抗菌药物治疗;然而,患者的病情并未改善,于同日死亡。