[Mesenteric ischemia: a severe complication in burn patient]

Area of Science:

• Gastroenterology
• Trauma Surgery
• Burn Medicine

Background:

• Severe burns frequently cause gastrointestinal complications, including paralytic ileus, bleeding, ulcers, and necrotizing cholecystitis.
• Acute intestinal necrotizing ischemia is a recognized, though not precisely quantified, complication in severe burn patients.
• Common causes of intestinal ischemia include arterial embolism, thrombosis, venous thrombosis, and non-occlusive mesenteric ischemia.

Observation:

• A 45-year-old male with 42% total burn surface area (TBSA) and inhalation injury, resulting from self-immolation with gasoline, presented with severe burns to the face, throat, chest, arms, and abdominal wall.
• The patient had an Abbreviated Burn Severity Index (ABSI) score of 10.
• Aortic valve thrombus and tachycardic dysrhythmia led to embolization, causing acute intestinal ischemia.

Findings:

• The patient experienced acute intestinal ischemia secondary to embolic events.
• Surgical intervention involved resection of the necrotic small intestine.
• The patient's postoperative course was uncomplicated.

Implications:

• This case highlights the critical link between cardiac thrombus/dysrhythmia and gastrointestinal complications in severe burn patients.
• Prompt surgical management, including resection of necrotic bowel, is vital for improving outcomes in these complex cases.
• Further research into the incidence and specific management strategies for acute intestinal ischemia in severe burn patients is warranted.