2003 Volume 23 Issue 6 Pages 985-989
A 68-year-old man had been diagnosed as having myocardial infarction, and had received anticoagulant therapy. He noticed tarry stools, and began to complain of abdominal pain and nausea with anemia two days after admission. The thickness of the intestine revealed by an abdominal CT scan suggested mesenteric ischemia, and an emergency operation was performed. Intraoperative findings confirmed, regional necrosis of the small intestine extending 3m 30cm from a point 10cm distal from Treitz's ligament. We made a diagnosis of nonocclusive mesenteric infarction (NOMI), totally resected the necrotic small intestine, and made ileal and jejunal stomas. After the improvement of the patient's general condition, we performed a staged operation with the closure of the stomas on the 39th postoperative day. Consequently, the patient could take food orally, and he was discharged on the 79th day after the first operation. Amyloidosis was considered as the possible cause of NOMI from the results of the histopathological data.
