Preoperative Endoscopy in Nonocclusive Mesenteric Ischemia: A Report of Two Cases

Nonocclusive mesenteric ischemia (NOMI) is caused by arterial spasm, and in the case of non-reversible NOMI, surgery is required. In cases of extensive intestinal necrosis caused of by NOMI, ischemic anal canal changes are rare and the anal canal mucosa is usually preserved. We examined 2 cases of N...

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Published inNihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 25; no. 3; pp. 521 - 523
Main Authors Hara, Takashi, Nenohi, Masaaki, Numata, Akihiko, Katoh, Hiroyuki
Format Journal Article
LanguageJapanese
Published Japanese Society for Abdominal Emergency Medicine 2005
Subjects
nonocclusive mesenteric ischemia
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Summary:Nonocclusive mesenteric ischemia (NOMI) is caused by arterial spasm, and in the case of non-reversible NOMI, surgery is required. In cases of extensive intestinal necrosis caused of by NOMI, ischemic anal canal changes are rare and the anal canal mucosa is usually preserved. We examined 2 cases of NOMI in which marked bilateral internal iliac artery calcification was identified by abdominal CT with ischemic changes extending to the anal canal visualized on by preoperative endoscopy. We performed a total colectomy and extensive small intestine resection. The anal canal ischemia was due to reduced internal iliac arterial blood flow secondary to arterial sclerosis. Preoperative endoscopy may therefore help disease management in cases of NOMI with severe internal iliac artery arteriosclerosis.
ISSN:1340-2242
1882-4781
DOI:10.11231/jaem1993.25.521