Enteral nutrition and acute mesenteric ischemia

Iapichino, G.; Danilo, Radrizzani; Marco, Zanello; Tetamo, Romano; Buono, Salvatore

doi:10.1007/s00134-022-06689-y

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…The possibility that ENinduced NOMI in Case 2 cannot be ruled out. However, all the reported NOMI cases induced by EN were in poor general condition [8,9]. In contrast, our two patients were not in critical condition and NOMI was not foreseeable.…”

Section: Discussioncontrasting

confidence: 61%

“…Non-occlusive mesenteric ischemia (NOMI) occurs without occlusion of the mesenteric arteries, accounting for 20%-30% of all acute mesenteric ischemia cases with an extremely high mortality rate [1][2][3]. As risk factors of NOMI, followings are included: older than 50 years with a history of ischemic heart disease [1], atherosclerosis [4], dialysis [5,6], diabetes mellitus [7], and enteral nutrition (EN) [8,9]. However, it may be difficult to clarify risk factors because this disorder frequently occurs in critically ill patients [10].…”

Section: Introductionmentioning

confidence: 99%

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Fulminant Non-occlusive Mesenteric Ischemia After Head Trauma: Report of Two Cases

Yamada,

Tomita,

Iwamoto

et al. 2024

Cureus

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There have been no case reports of non-occlusive mesenteric ischemia (NOMI) following head trauma. Our two patients with non-surgical traumatic intracerebral hemorrhage succumbed to NOMI one week after the injury. Both were women over age 80 years and were clinically improving before NOMI occurred. One patient had been eating since admission, while the other had not, which prompted the initiation of enteral nutrition on day 5. The patients shared many characteristics: 1) over age 80 years; 2) minor brain contusion; 3) constipation for a week; 4) minimal abdominal symptoms; 5) rapidly developing leukocytosis, hyperglycemia, hypernatremia, and elevated blood urea nitrogen; 6) massive diarrhea with a small amount of blood on the same day that laboratory data became abnormal; and 7) fever and shock developed shortly after diarrhea appeared. Because of the fulminant worsening of the condition, shock status, and old age, surgical intervention was considered high risk and not performed in either patient. In retrospect, if NOMI had been diagnosed earlier when the acute pancreatitis-like symptoms began, surgical intervention may have saved their lives. Clinicians should be aware that NOMI can occur after relatively minor head trauma, which can cause death if the diagnosis is delayed.

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Section: Discussioncontrasting

confidence: 61%