Abstract
There have been only a limited number of previous studies on the evaluation of intestinal blood flow perfusion by indocyanine green (ICG) fluorescence angiography, especially for strangulated intestinal obstruction in children. A two-month-old boy was admitted to our hospital owing to repeated diarrhea and vomiting. Although he was initially diagnosed with viral gastroenteritis and his diarrhea improved the next day, strangulated intestinal obstruction was revealed on the third day of hospitalization. An emergency laparotomy was undertaken, and we found that a 40 cm length of the ileum was strangulated by the mesodiverticular band. The discoloration of the intestine was 4 cm from the oral side of the Meckel diverticulum to the terminal ileum. After the strangulation was released, ICG fluorescence angiography was performed to explore the possibility of preserving the ileocecal valve. Blood flow perfusion was observed up to 2 cm proximal to the ileocecal valve. Therefore, the necrotic bowel was resected while preserving the ileocecal valve, and the ileum was anastomosed end-to-end style. His postoperative course was uneventful and he was discharged on the 11th postoperative day. The ICG fluorescence angiography in this case was effective for objectively evaluating the blood flow perfusion in the ileocecal region and preserving the ileocecal valve. Still, a method for the detailed evaluation by ICG fluorescence angiography has not been established, and further research with the accumulation of cases should be conducted.
