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KMID : 0360720140270040204
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Journal of the Korean Society Traumatology
2014 Volume.27 No. 4 p.204 ~ p.207
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Non-occlusive Mesenteric Ischemia (NOMI) Secondary to Traumatic Hemorrhagic Shock: Case Report
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Lim Kyoung-Hoon
Jung Hee-Kyung
Cho Ja-Yun
Lee Sang-Cjeol
Park Jin-Young
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Abstract
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Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow- up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation.
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KEYWORD
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Non-occlusive mesenteric ischemia, Trauma, Hemorrhagic shock
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