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- Title
A case of non-occlusive mesenteric ischemia complicated by intestinal amyloidosis that was saved without intestinal resection.
- Authors
Satoshi Fukai; Suguru Hayase; Atsushi Ozeki; Yuya Maruyama; Hisahito Endo; Taisuke Ito; Yoshimasa Ishii; Koji Kono
- Abstract
Several cases of gastrointestinal amyloidosis and non-occlusive mesenteric ischemia (NOMI) have been reported in Japan, suggesting that amyloid deposition in the gastrointestinal tract can be a risk factor for the development of NOMI. We herein present a case of NOMI complicated by gastrointestinal amyloidosis which was treated without intestinal resection. The patient was an 81-year-old man who came to our hospital with a complaint of hematemesis. Blood pressure reductions were observed, and an abdominal CT scan showed gas in the intestinal wall and portal vein. A diagnosis of intestinal necrosis was made, and an emergency laparotomy was performed. The intestinal tract and mesentery were reddish, but the overall intestinal color and peristalsis were fine. Despite the diagnosis of NOMI, it was judged that irreversible intestinal necrosis had not yet occurred, and the operation was completed only by exploratory laparotomy without intestinal resection. Post-operatively, the patient was admitted to the ICU for circulatory management. His general condition gradually improved, and he was discharged on post-operative day 14 from the hospital. After discharge from hospital, the patient complained of diarrhea, and an upper gastrointestinal endoscopy was performed. A diagnosis of gastrointestinal amyloidosis was made based on findings from biopsies of the stomach and duodenum and association of NOMI and gastrointestinal amyloidosis was suspected.
- Publication
Fukushima Medical Journal, 2023, Vol 73, Issue 1, p7
- ISSN
0016-2582
- Publication type
Article