A CASE OF ISCHEMIC ENTEROCOLITIS IN A HEMODIALYSIS PATIENT EFFECTIVELY TREATED BY SURGERY AND HYPERBARIC OXYGEN THERAPY

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  • 外科治療および術後高気圧酸素療法が奏効した慢性腎不全に合併した虚血性腸炎の1例

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Abstract

A 57-year-old man on hemodialysis since 1993 was admitted to our hospital, because of shock status associated with abdominal pain and distention. Plain abdominal X-P and CT showed dilatation of intestine and colonoscopy revealed necrosis of the colonic mucosa. We therefore made a diagnosis of peritonitis secondary to necrotic ischemic enterocolitis and performed emergency surgery. Subtotal colectomy and resection of 10-cm of terminal ileum was performed because of the widespread necrosis of the colon and partial necrosis of the ileum discovered at laparotomy. After the operation the patient became being possible to oral taking with hyperbaric oxygen therapy (HBO), but he died of acute myocardial infarction 2 months after the operation. Although ischemic enterocolitis in hemodialysis patients almost always has a poor outcome, surgical tretment and HBO may be effective, as in our case.

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