Non-occlusive mesenteric ischaemia associated with anorexia nervosa

Area of Science:

• Gastroenterology
• Internal Medicine
• Critical Care Medicine

Background:

• Non-occlusive mesenteric ischaemia (NOMI) presents a critical surgical emergency.
• Anorexia nervosa requires comprehensive medical and nutritional oversight.
• Concurrent management of these conditions poses significant challenges.

Observation:

• A 54-year-old female patient with a history of anorexia nervosa and undergoing chronic hemodialysis presented with acute abdominal pain and shock.
• Clinical examination indicated diffuse peritonitis.
• Computed tomography revealed extensive bowel ischaemia.

Findings:

• Emergency laparotomy confirmed NOMI affecting the distal ileum to the transverse colon.
• A staged surgical approach combined with intensive medical management, focusing on nutritional and electrolyte balance, was implemented.
• The patient survived following this complex treatment strategy.

Implications:

• This case underscores the feasibility of managing NOMI in patients with anorexia nervosa.
• It emphasizes the critical role of meticulous, interdisciplinary collaboration for achieving positive outcomes in complex cases.
• Optimal nutritional and electrolyte management are key components in the survival of patients with NOMI and comorbid conditions.