Publication details

Steal fenoménem indukovaná non-okluzivní mesenterická ischémie jako časná komplikace implantované aorto-biprofundální rekonstrukce

Title in English Steal-phenomenon induced Non-Occlusive Mesenteric Ischemia as an early complication after aortobiprofundal bypass implantation
Authors

BIROŠ Ernest STAFFA Robert KŘÍŽ Zdeněk KONEČNÝ Zdeněk NOVOTNÝ Tomáš

Year of publication 2019
Type Article in Periodical
Magazine / Source Vaskulárna medicína
MU Faculty or unit

Faculty of Medicine

Citation
Web http://www.solen.sk/pdf/b2feb1a52b9ee2d4cdb333e6478d81e3.pdf
Keywords non-occlusive mesenteric ischemia; steal phenomenon; postoperative ileus; aortoiliac occlusive disease
Description Introduction: Non-Occlusive Mesenteric Ischemia (NOMI) is one of the forms of acute mesenteric ischemia. It develops despite mesenteric arteries and veins being patent when mesenteric blood perfusion is reduced by a non-occlusive cause. Steal-phenomenon induced NOMI in a patient after aorto-biprofundal (Ao-biDFA) bypass implantation represents its new etiopathogenesis. Case report: This case report describes postoperative course of the patient who underwent aorto-biprofundal bypass implantation. Conclusions: Aorto-femoral reconstruction can cause postoperative hypoperfusion of mesenteric vascular bed when it´s done at presence of previously asymptomatic stenoses of mesenteric arteries (TC, AMS). Steal-phenomenon is the etiopathologic mechanism responsible for mesenteric hypoperfusion in this case. If the condition is not corrected, it can progress to acute non-occlusive mesenteric ischemia with transmural bowel necrosis. Early recognition together with endovascular therapy of mesenteric artery stenoses and laparostoma formation helped us to avoid development of transmural bowel ischemia. We should be aware of this possible complication in patients undergoing aorto-femoral reconstruction because of aortoiliac occlusive disease.
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