Acute non-occlusive mesenteric ischemia in patients with various types of comorbidities and postoperative complications: clinical case and observation.

Abstract

Aim. To enhance the outcomes of treating patients with acute non-occlusive mesenteric ischemia (focal) following colostomy, aiming to gain a better understanding of the prevalent risk factors for complications and exploring ways of their reduction.Materials and methods. A clinical case detailing the treatment of a patient with acute non-occlusive mesenteric ischemia amidst abdominal sepsis and stoma necrosis, compounded by inflammatory disease of the spinal cord membranes, is presented. Additionally, the clinical observation of a patient experiencing postoperative complications, including coronavirus infection and bilateral hydrothorax, is provided.Results. In a patient presenting severe coronary pathology alongside a nuanced clinical manifestation of mesenteric ischemia in the delayed phase, a surgical intervention involving intestinal tract resection and subsequent stoma removal was conducted. Regrettably, stoma necrosis ensued, necessitating reconstructive surgery. The patient’s initial critical state, compounded by the requirement for repeated surgical intervention, precipitated a swift progression of multiple organ failure, culminating in mortality. Conversely, another patient, postoperatively diagnosed with coronavirus infection and bilateral hydrothorax, exhibited amelioration in clinical status following administered treatment, ultimately warranting hospital discharge.Conclusions. Early diagnosis and timely surgical intervention contribute to improving the prognosis of treatment. Early postoperative complications and repeated surgical interventions significantly worsen the prognosis.