Nonocclusive Mesenteric Infarction: A Rare Complication of Continuous
Ambulatory Peritoneal Dialysis
Z. Malazgirt[1],
N. Arik[2], H. Guven[3],
M. F. Gursel[1] and I. Akpolat[4]
Departments of Surgery[1], Nephrology[2],
Emergency Medicine[3] and Pathology[4],
School of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Corresponding address:
H. Guven, Department of Emergency Medicine, School of Medicine,
Ondokuz Mayis University, 55139 Kurupelit, Samsun, Turkey. Tel:
+90 362 457 6000-2994; E-mail: hakang@omu.edu.tr
Abstract
This report describes an uncommon condition,
nonocclusive mesenteric ischemia (NOMI) in
a patient with end-stage renal disease on continuous peritoneal
dialysis therapy. The patient
presented with nonspecific abdominal symptoms and leucocytosis
which later progressed to an
acute abdomen due to generalized peritonitis of unknown origin.
She had been hospitalized with an
episode of hypotension four days before surgery. At emergency
laparotomy, we detected an unusual
form of ileal infarction that was characterized by multiple, variable
sized and patchy-looking
necrotic areas, of which a few were perforated. We resected the
infarcted ileal segment, and did
a proximal ileostomy. The patient was as well as she could be
in relation to her chronic renal
disease. We emphasize the need for surgeons to consider NOMI as
a cause of peritonitis in patients
with renal failure.
Key words
Peritonitis, nonocclusive mesenteric ischemia,
continuous ambulatory peritoneal dialysis,
emergency laparotomy
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