A Case of an Elderly Patient with Slowly Progressive Type 1 Diabetes Who Developed Severe Nonocclusive Mesenteric Ischemia without Predisposing Events

Kenta Hara; Hisafumi Yasuda; Takashi Arai; Sonoko Miyoshi; Osamu Kubokawa; Hiroyuki Mori; Taichi Akisaki; Yoshiaki Kido; Koichi Yokono; Hozuka Akita

doi:10.2169/internalmedicine.51.6945

CASE REPORTS

A Case of an Elderly Patient with Slowly Progressive Type 1 Diabetes Who Developed Severe Nonocclusive Mesenteric Ischemia without Predisposing Events

Kenta Hara, Hisafumi Yasuda, Takashi Arai, Sonoko Miyoshi, Osamu Kubokawa, Hiroyuki Mori, Taichi Akisaki, Yoshiaki Kido, Koichi Yokono, Hozuka Akita

Author information

Kenta Hara
Department of General Internal Medicine, Kobe University Hospital, Japan
Hisafumi Yasuda
Department of General Internal Medicine, Kobe University Hospital, Japan
Takashi Arai
Department of General Internal Medicine, Kobe University Hospital, Japan
Sonoko Miyoshi
Department of General Internal Medicine, Kobe University Hospital, Japan
Osamu Kubokawa
Department of General Internal Medicine, Kobe University Hospital, Japan
Hiroyuki Mori
Department of General Internal Medicine, Kobe University Hospital, Japan
Taichi Akisaki
Department of General Internal Medicine, Kobe University Hospital, Japan
Yoshiaki Kido
Kobe University Graduate School of Health Sciences, Japan
Koichi Yokono
Department of General Internal Medicine, Kobe University Hospital, Japan
Hozuka Akita
Department of General Internal Medicine, Kobe University Hospital, Japan

Keywords: colonic ischemia, NOMI, oxidative stress, predisposing events, slowly progressive type 1 diabetes

JOURNAL OPEN ACCESS

2012 Volume 51 Issue 9 Pages 1065-1068

DOI https://doi.org/10.2169/internalmedicine.51.6945

Details

Abstract

A 72-year-old woman with slowly progressive type 1 diabetes (SPIDDM) was admitted to our hospital because of increasing abdominal pain and diarrhea. The patient was diagnosed with nonocclusive mesenteric ischemia (NOMI), and a subtotal colonectomy was performed successfully. The resected sample revealed transmural gangrenous necrosis of the colon and rectum. This case is interesting because the severe NOMI occurred in a SPIDDM patient without common predisposing events such as hypoperfusion. Prolonged generation of reactive oxygen species in SPIDDM, together with the decline in adaptive response to oxidative stress with aging, might be an exacerbating factor for ischemic injury in the elderly.

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