Extensive colonic necrosis following cardiac arrest and successful cardiopulmonary resuscitation: report of a case and literature review
| Autor: | Athanasios Stathoulopoulos, Michael K. Digalakis, Iraklis E. Katsoulis, Alexia Balanika, Ioanna Gogoulou, Maria Sakalidou |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Necrosis medicine.medical_treatment lcsh:Surgery Non-occlusive ischaemia Rectum Review Ileostomy Laparotomy medicine Cardiopulmonary resuscitation Colonic necrosis business.industry lcsh:Medical emergencies. Critical care. Intensive care. First aid Transverse colon lcsh:RD1-811 lcsh:RC86-88.9 Abdominal distension medicine.disease Surgery medicine.anatomical_structure CPR Emergency Medicine medicine.symptom business Vasculitis |
| Zdroj: | World Journal of Emergency Surgery : WJES World Journal of Emergency Surgery, Vol 7, Iss 1, p 35 (2012) |
| ISSN: | 1749-7922 |
| Popis: | Non-occlusive colonic ischaemia is a recognized albeit rare entity related to low blood flow within the visceral circulation and in most reported cases the right colon was affected. This is the second case report in the literature of extensive colonic necrosis following cardiac arrest and cardiopulmonary resuscitation (CPR). A 83-year-old Caucasian woman was admitted to our hospital due to a low energy hip fracture. On her way to the radiology department she sustained a cardiac arrest. CPR started immediately and was successful. A few hours later, the patient developed increasing abdominal distension and severe metabolic acidocis. An abdominal multidetector computed tomography (MDCT) scan was suggestive of intestinal ischaemia. At laparotomy, the terminal ileum was ischaemic and extensive colonic necrosis was found, sparing only the proximal third of the transverse colon. The rectum was also spared. The terminal ileum and the entire colon were resected and an end ileostomy was fashioned. Although the patient exhibited a transient improvement during the immediate postoperative period, she eventually died 24h later from multiple organ failure. Histology showed transmural colonic necrosis with no evidence of a thromboembolic process or vasculitis. Therefore, this entity was attributed to a low flow state within the intestinal circulation secondary to the cardiac arrest. |
| Databáze: | OpenAIRE |
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