血液透析患者に発症したnonocclusive mesenteric ischemiaの2例

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  • Two cases of nonocclusive mesenteric ischemia in hemodialysis patients
  • ショウレイ ケツエキ トウセキ カンジャ ニ ハッショウ シタ nonocclusive mesenteric ischemia ノ 2レイ

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Case 1 : A 53-year-old man was on hemodialysis for diabetic nephropathy. He developed abdominal pain after dinner, which worsened thereafter. On the following day, he was brought to our hospital before dawn. Computed tomography showed hepatic portal venous gas. A necrotic small intestine was suspected, and an emergency operation was performed. The operative findings included a segmental necrotic small intestine. The necrotic small intestine was resected. The histopathological examination of the resected specimen did not show thrombi in the blood vessels. Nonocclusive mesenteric ischemia (NOMI) was diagnosed.<BR>Case 2 : A 58-year-old man required hemodialysis for chronic renal disease. He was admitted to the cardiovascular surgery department of our hospital for arteriosclerosis obliterans. He experienced abdominal pain at midnight, which worsened thereafter. Computed tomography showed gas in the branches of the superior mesenteric vein and the small intestine wall. Necrotic small intestine was suspected, and an emergency operation was performed. The operative findings included segmental necrotic small intestine. The necrotic small intestine was resected. The histopathological examination of the resected specimen did not show thrombi in the blood vessels. NOMI was diagnosed. Hemodialysis patients have a high risk of NOMI. Therefore, the possibility of NOMI should be considered in hemodialysis patients.

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