A Successfully Treated Case of an Ischemic Colonic Necrosis with Septic Shock in a Patient of Very-advanced Age ( 102-Year-Old).

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  • 敗血症性ショック合併超高齢者（１０２歳）虚血性大腸壊死の１救命例

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Abstract

We treated successfully a case of ischemic colonic necrosis with septic shock in a patient of very-advanced age by a massive colectomy. A 102-year-old woman was admitted to our hospital because of vomit-ing and abdominal pain. On admission, she was critically ill, presenting symptoms of septic shock. Under the diagnosis of strangulated ileus, an emergency laparotomy was carried out. On laparotomy, a massive necrosis of the colon between the hepatic flexure and the distal end of the descending colon was revealed, and, was his-tologically proven to be caused by ischemic colonic necrosis. Since the patient had many risk factors, including dehydration, septic shick, advanced age, and a highly invasive operation, her hemodynamic and respiratory condition after the operation was quite unstable. Therefore, a close watch on these states was kept for 7 days after the operation, using an S-G catheter. During postoperative treatments, attention was focussed on main taining a hyperdynamic state based on accurate hemodynamic and respiratory parameters. Owing to these meticulous postoperative treatments, a successful outcome was achieved.

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