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Updated: Sep 22, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
[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.
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.
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.
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