Aortic dissection tied with Nonocclusive mesenteric ischemia: BMC

Nonocclusive mesenteric ischemia (NOMI) is defined as acute intestinal ischemia because of decreased blood flow in mesenteric vessels. Only a few cases of NOMI that occur secondary to aortic dissection (AD) have been reported, resulting in the lack of sufficient knowledge of diagnosis and treatment.

They aimed to report a case of NOMI caused by type B Aortic Dissection. A 26-year-old male patient was transferred to our hospital with the diagnosis of NOMI and aortic dissection in April 2018. Abdominal computed tomography (CT) assists in the diagnosis of paralytic intestinal obstruction, intestinal wall pneumatosis, and perforation. Emergency laparotomy revealed that the bowel wall supplied by the superior mesenteric artery (SMA) was pale with the palpable but weak pulsation of the parietal artery. The small intestine was extremely dilated with a paper-thin, fragile wall that was ruptured easily and could not be sutured. In this case, extensive resection and segmental drainage were done. Postoperatively, the digestive tract was reconstructed. However, the patient suffered from iron deficiency anaemia and short bowel syndrome eight months later and unfortunately died from long-term complications.

Thus, aortic dissection leads to the continuous decrease in blood pressure and blood flow to the SMA, considered a predisposing factor for NOMI. During the treatment, extensive resection and segmental drainage are the optimal surgical strategy, which can make benefit in emergencies especially.

Reference:

Nonocclusive mesenteric ischemia caused by type B aortic dissection: a case report by Mengchao Sheng, et al. published in the BMC Surgery

https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-022-01656-2