Non-occlusive mesenteric ischemia associated with enteral feeding after esophagectomy for esophageal cancer: report of two cases and review of the literature

Surgical Case Reports
Daisuke KuritaHiroyuki Daiko

Abstract

Non-occlusive mesenteric ischemia (NOMI) is a rare but life-threatening complication of early postoperative enteral feeding. We herein report two patients who developed NOMI during enteral feeding after esophagectomy. In case 1, a 75-year-old man with no medical history was diagnosed with multiple primary cancers of the esophagus, stomach, and kidney. He underwent percutaneous endoscopic gastrostomy tube placement followed by thoracoscopic esophagectomy and cervical esophagostomy placement as the first-stage operation. Gastrostomy feeding was started on postoperative day (POD) 3 with a polymeric formula (ENSURE H®). On POD 7, he developed acute abdominal pain and distension with bloody drainage through the gastrostomy tube. Dynamic computed tomography showed massive hepatic portal venous gas and pneumatosis intestinalis. Angiography showed diffuse spasms in the branches of the superior mesenteric artery. Under a diagnosis of NOMI, we started intra-arterial infusion of papaverine and prostaglandin E1. His symptoms improved, and he was discharged on POD 48. In case 2, a 68-year-old man with diabetes and atrial fibrillation was diagnosed with esophageal cancer. His medical history was significant for pylorus-preserving gastrectomy...Continue Reading

References

Jan 1, 1988·American Journal of Surgery·P Smith-Choban, M H Max
Jun 30, 2009·Annals of the Royal College of Surgeons of England·Duncan Rc SpaldingRobin Cn Williamson
May 19, 2010·Journal of Cancer Research and Therapeutics·Sajid S QureshiRajesh C Mistry
Jun 12, 2010·International Journal of Surgery·Mohd Lateef WaniIfat Irshad
Nov 23, 2010·JAAPA : Official Journal of the American Academy of Physician Assistants·Andrea N SarapJennifer Childers
Mar 2, 2012·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·T FujitaM Nishimura
Aug 19, 2014·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Teus J WeijsMisha Dp Luyer
Mar 11, 2016·The New England Journal of Medicine·Daniel G Clair, Jocelyn M Beach
Jun 25, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Omer S Al-TaanDavid J Bowrey
Sep 29, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·S A SethuramanDaniel E Abbott

❮ Previous
Next ❯

Methods Mentioned

BETA
dissection

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.