Non-occlusive mesenteric ischemia after staged revascularization of visceral trunks and lower extremities

Abstract

Introduction: chronic mesenteric ischemia (CMI) is a pathology with high morbidity and mortality rates since it’s usually associated with severe systemic arteriosclerosis. Revascularization of visceral trunks can be staggered in order to improve the nutritional status of the patient. Non-occlusive mesenteric ischemia is a type of acute mesenteric ischemia that frequently occurs in the postoperative period of major surgery or as a complication in critical patients. Case report: we present the case of a female patient with chronic mesenteric ischemia and critical ischemia of the lower limbs due to aortoiliac disease in which two-staged revascularization was performed. The patient had a torpid postoperative period as a result of a non-occlusive mesenteric ischemia which led to a fatal outcome. Discussion: non-occlusive mesenteric ischemia is a type of acute mesenteric ischemia that can occur in two contexts: either in a systemic hypoperfusion, or in the context of intestinal hypoperfusion after a precipitating event such as a surgical intervention. Diagnosis and early treatment are essential to trying to reduce mortality rates that reach 70-90 % of the cases. Endovascular treatment is often the first choice although bypass surgery still plays an important role in cases of extensive disease.