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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Multimodality Diagnosis of Mesenteric Ischemia
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[Non-occlusive mesenteric ischemia in reconstructive digestive tract surgery].

D V Ruchkin1, D E Okonskaya1, G G Karmazanovsky1

  • 1Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.

Khirurgiia
|May 20, 2022
PubMed
Summary

Non-occlusive mesenteric ischemia (NOMI) after digestive surgery is rare but deadly, often presenting as septic shock. Early diagnosis is challenging, with extensive necrosis linked to intraoperative ischemia.

Keywords:
conduit necrosisesophagectomyesophagoplastygastrectomynon-occlusive mesenteric ischemia

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Critical Care Medicine

Background:

  • Non-occlusive mesenteric ischemia (NOMI) is a rare but severe complication following digestive tract surgery.
  • Understanding NOMI mechanisms is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the mechanisms and clinical presentation of non-occlusive mesenteric ischemia (NOMI) after reconstructive digestive tract surgery.

Main Methods:

  • Retrospective analysis of 10 patients who developed NOMI between 2015 and 2021.
  • Review of surgical parameters, clinical course, and outcomes.

Main Results:

  • NOMI occurred in 0.4% of patients, with a high mortality rate of 80%.
  • Fulminant NOMI developed in 60% of cases, leading to multiple organ failure and septic shock.
  • Lactic acidosis was an early indicator in 70% of patients.

Conclusions:

  • NOMI often presents as fulminant multivisceral necrosis and septic shock, making early diagnosis difficult.
  • Extensive visceral necrosis may be linked to intraoperative critical ischemia of digestive organs.