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Related Concept Videos

Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...

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Multimodality Diagnosis of Mesenteric Ischemia
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Nonocclusive mesenteric ischemia caused by type B aortic dissection: a case report.

Mengchao Sheng1, Wei Gong2, Kui Zhao1

  • 1Second Affiliated Hospital of Soochow University, Suzhou, China.

BMC Surgery
|June 6, 2022
PubMed
Summary

Nonocclusive mesenteric ischemia (NOMI) secondary to aortic dissection (AD) is rare. This case highlights AD as a NOMI predisposing factor, with extensive resection and drainage as optimal emergency surgical management.

Keywords:
Aortic dissectionCase reportExtensive resectionNOMISegmental drainage

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Area of Science:

  • Vascular Surgery
  • Gastrointestinal Surgery
  • Cardiovascular Surgery

Background:

  • Nonocclusive mesenteric ischemia (NOMI) is acute intestinal ischemia due to reduced mesenteric blood flow.
  • NOMI secondary to aortic dissection (AD) is infrequently reported, limiting understanding of its diagnosis and treatment.

Observation:

  • A case of NOMI secondary to type B aortic dissection in a 26-year-old male.
  • Abdominal CT revealed paralytic intestinal obstruction, pneumatosis, and perforation.
  • Laparotomy showed a pale, ischemic small bowel with a fragile, easily ruptured wall.

Findings:

  • The patient underwent extensive bowel resection and segmental drainage due to unresectable ischemia.
  • Postoperative reconstruction was performed, but complications arose.
  • The patient developed iron deficiency anemia and short bowel syndrome, ultimately succumbing to long-term complications.

Implications:

  • Aortic dissection can predispose individuals to NOMI by reducing superior mesenteric artery (SMA) blood flow.
  • Extensive resection and segmental drainage represent an optimal emergency surgical strategy for NOMI.
  • This case highlights the critical need for awareness and timely management of NOMI in AD patients.