Τίτλος:
Nonocclusive mesenteric ischemia: A lethal complication in peritoneal dialysis patients
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Nonocclusive mesenteric ischemia (NOMI) is a relatively uncommon disorder, seen primarily in elderly patients with cardiac disease, and is characterized by progressive intestinal ischemia leading to infarction, sepsis, and death. It is suspected of being the underlying cause in at least 20%-30% of acute mesenteric ischemia patients. End-stage renal disease patients are among the highest risk populations for developing this lethal complication; however, NOMI is not unique to hemodialysis and can occur in peritoneal dialysis patients as well. Unfortunately, the presentation of NOMI is very similar to that of peritonitis. The key to correct diagnosis is a high index of suspicion in predisposed patients. The high mortality rate is a clear reflection of failure to recognize the syndrome at an earlier, treatable stage. We present our case experience and an extensive review of the literature regarding this dreadful complication that may be reversible if considered early as a possible etiology and the appropriate diagnostic maneuvers undertaken. Copyright © 2007 International Society for Peritoneal Dialysis.
Συγγραφείς:
Archodovassilis, F.
Lagoudiannakis, E.E.
Tsekouras, D.K.
Vlachos, K.
Albanopoulos, K.
Fillis, K.
Manouras, A.
Bramis, J.
Περιοδικό:
Peritoneal Dialysis International
Λέξεις-κλειδιά:
acenocoumarol; acetylsalicylic acid; amiodarone; amylase; anticoagulant agent; clonidine; creatinine; gentamicin; hemoglobin; nadroparin; phosphate binding agent; pravastatin; salbutamol; urea; vancomycin, abdominal distension; abdominal pain; aged; amylase blood level; aorta atherosclerosis; bacterial peritonitis; case report; chronic obstructive lung disease; colon resection; continuous ambulatory peritoneal dialysis; creatinine blood level; differential diagnosis; drug substitution; drug withdrawal; Escherichia coli; female; fever; fluid resuscitation; gangrene; Gram negative infection; heart atrium fibrillation; hemoglobin blood level; histopathology; human; human tissue; hypertension; hypotension; ileorectal anastomosis; intestine ischemia; kidney failure; Klebsiella pneumoniae; laboratory test; laparotomy; leukocyte count; metabolic acidosis; nausea; nonhuman; nonocclusive hemorrhagic bowel necrosis; peritoneal dialysis; peritoneal fluid; physical examination; priority journal; review; sepsis; urea blood level; vomiting
DOI:
10.1177/089686080702700206
