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Septic state and ileus as the late complications of non-occlusive mesenteric ischemia — case report
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Abstract
Acute bowel ischemia is a relatively rare condition, but with a very serious prognosis. It may be caused by obstruction of the visceral artery, arterial spasm or reduction in visceral perfusion (NOMI, non-occlusive ischemia), or visceral venous thrombosis. In this paper we present a case of a male patient, in whom during septic shock in the course of pneumonia, probably NOMI occurred. The consequence of this complication were recurrent febrile states and rapidly progressing, multisegmental narrowing of the small bowel resulting in the ileus within four months. It required small bowel resection, ileostomia and parenteral nutrition. We failed to sufficiently document the source of these late NOMI complications and introduce the surgery before dissemination of infection of faecal streptococci. These infection focuses were likely the source of nutritional catheter contagion and recurrent septic conditions, which together with stroke, finally caused patient’s death.
Abstract
Acute bowel ischemia is a relatively rare condition, but with a very serious prognosis. It may be caused by obstruction of the visceral artery, arterial spasm or reduction in visceral perfusion (NOMI, non-occlusive ischemia), or visceral venous thrombosis. In this paper we present a case of a male patient, in whom during septic shock in the course of pneumonia, probably NOMI occurred. The consequence of this complication were recurrent febrile states and rapidly progressing, multisegmental narrowing of the small bowel resulting in the ileus within four months. It required small bowel resection, ileostomia and parenteral nutrition. We failed to sufficiently document the source of these late NOMI complications and introduce the surgery before dissemination of infection of faecal streptococci. These infection focuses were likely the source of nutritional catheter contagion and recurrent septic conditions, which together with stroke, finally caused patient’s death.
Keywords
bowel ischemia, sepsis, ileus, short bowel syndrome
About this articleTitle
Septic state and ileus as the late complications of non-occlusive mesenteric ischemia — case report
Journal
Issue
Article type
Case report
Pages
60-70
Published online
2014-06-05
Page views
1190
Article views/downloads
3435
DOI
10.5603/aa.36243
Bibliographic record
Acta Angiologica 2014;20(2):60-70.
Keywords
bowel ischemia
sepsis
ileus
short bowel syndrome
Authors
Natalia Butt-Hussaim
Jacek Budzyński
Paweł Jarmocik
Zbigniew Banaszkiewicz
Małgorzata Dobosiewicz
Grzegorz Pulkowski
Władysław Sinkiewicz