A Successfully Treated Case of an Ischemic Colonic Necrosis with Septic Shock in a Patient of Very-advanced Age (102-Year-Old)

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 34; no. 1; pp. 68 - 72
• Main Authors: Fukui, Takami, Yokoo, Naoki, Yoshida, Takahiro, Tanaka, Chihiro, Azuma, Hisaya, Shiroko, Takashi, Kitakado, Yasuhito, Okamoto, Kiyohisa, Kato, Tatsushi, Yamaguchi, Tetsuya
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2001
• Subjects: a patient of super-advanced age; emergency operation; septic shock
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.34.68

We treated successfully a case of ischemic colonic necrosis with septic shock in a patient of very-advanced age by a massive colectomy. A 102-year-old woman was admitted to our hospital because of vomit-ing and abdominal pain. On admission, she was critically ill, presenting symptoms of septic shock. Under the diagnosis of strangulated ileus, an emergency laparotomy was carried out. On laparotomy, a massive necrosis of the colon between the hepatic flexure and the distal end of the descending colon was revealed, and, was his-tologically proven to be caused by ischemic colonic necrosis. Since the patient had many risk factors, including dehydration, septic shick, advanced age, and a highly invasive operation, her hemodynamic and respiratory condition after the operation was quite unstable. Therefore, a close watch on these states was kept for 7 days after the operation, using an S-G catheter. During postoperative treatments, attention was focussed on main taining a hyperdynamic state based on accurate hemodynamic and respiratory parameters. Owing to these meticulous postoperative treatments, a successful outcome was achieved.