Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Non-occlusive Mesenteric Ischemia (NOMI) Secondary to Traumatic Hemorrhagic Shock: Case Report

외상성 출혈성 쇼크 환자에서 발생한 비 폐쇄성 장간막 허혈

  • Lim, Kyoung Hoon (Trauma Center, Kyungpook National University Hospital) ;
  • Jung, Hee Kyung (Trauma Center, Kyungpook National University Hospital) ;
  • Cho, Jayun (Trauma Center, Kyungpook National University Hospital) ;
  • Lee, Sang Cjeol (Trauma Center, Kyungpook National University Hospital) ;
  • Park, Jinyoung (Trauma Center, Kyungpook National University Hospital)
  • 임경훈 (경북대학교병원 권역외상센터) ;
  • 정희경 (경북대학교병원 권역외상센터) ;
  • 조자윤 (경북대학교병원 권역외상센터) ;
  • 이상철 (경북대학교병원 권역외상센터) ;
  • 박진영 (경북대학교병원 권역외상센터)
  • Received : 2014.08.14
  • Accepted : 2014.09.03
  • Published : 2014.12.31
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Abstract

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.

Keywords

References

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