Successful surgical treatment for nonocclusive mesenteric ischemia of a wide area of the intestine accompanied by gastric conduit necrosis after esophagectomy for esophageal cancer: a case report and review of the literature

Surgical Case Reports
Kotaro MiuraKiyoshi Maeda

Abstract

Nonocclusive mesenteric ischemia (NOMI) has been reported to be a life-threating disease. Gastric conduit necrosis is known as a critical postoperative complication after esophagectomy for esophageal cancer. We encountered a rare case of NOMI of a wide area of the intestine accompanied by gastric conduit necrosis after esophagectomy, which was successfully treated with an emergency operation. A 67-year-old man presented with dysphagia. He was diagnosed with middle thoracic advanced esophageal cancer. After neoadjuvant chemotherapy, he underwent subtotal esophagectomy with lymphadenectomy and gastric conduit reconstruction. On postoperative day (POD) 2, he had diarrhea, high fever, and low blood pressure, which were treated with catecholamines. Laboratory data revealed acidosis and severe sepsis with multi-organ failure, including the kidneys. Although enhanced computed tomography did not exhibit definite findings of bowel ischemia, upper gastrointestinal endoscopy revealed necrotic mucosal changes in the whole gastric conduit. Therefore, we made a diagnosis of septic shock caused by gastric conduit necrosis and performed an emergency operation. When we explored the abdominal cavity, we found not only gastric conduit necrosis bu...Continue Reading

References

Apr 27, 2002·European Radiology·Markus TrompeterPeter Reimer
May 19, 2010·Journal of Cancer Research and Therapeutics·Sajid S QureshiRajesh C Mistry
Oct 9, 2014·La Radiologia medica·Maria Antonietta Mazzei, Luca Volterrani
Oct 31, 2015·Thoracic Surgery Clinics·Karen J Dickinson, Shanda H Blackmon
Mar 11, 2016·The New England Journal of Medicine·Daniel G Clair, Jocelyn M Beach
Aug 11, 2017·World Journal of Emergency Surgery : WJES·Miklosh BalaFausto Catena
Sep 29, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·S A SethuramanDaniel E Abbott
May 7, 2019·World Journal of Gastrointestinal Surgery·Antonios AthanasiouEwen A Griffiths

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Citations

Feb 26, 2021·Curēus·Sanjiv GrayLatha Ganti
Mar 9, 2021·Clinical Journal of Gastroenterology·Kaoru KatanoTsutomu Maeda

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Methods Mentioned

BETA
X-ray
SMA
sedation

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