2019 Volume 39 Issue 1 Pages 073-077
An 86-year-old female presented to our institute with diarrhea, vomiting and disturbance of consciousness. At the time of arrival, the patient was in a state of shock. Enhanced abdominal computed tomography demonstrated thickening of the transverse colonic wall and marked dilatation of the small intestine and colon. The patient was diagnosed as having obstructive colitis (OC) due to transverse colon cancer and septic shock due to bacterial translocation, and was taken to the operating room for urgent laparotomy. The operative findings were consistent with the preoperative diagnosis. In addition, a wide range of blood flow-defective were seen in the small intestine. Therefore, we diagnosed non-occlusive mesenteric ischemia （NOMI） caused by OC and performed extensive small intestinal resection, right hemicolectomy and jejunostomy. The patient recovered and was discharged on day 82 post-surgery. This case is extremely interesting from the point of view of identifying the mechanism underlying the development of this condition. Prompt laparotomy should be considered as one of the important treatment strategies for patients with severe disease and in poor physical condition.
