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Sato, Tamie; Hasegawa, Shigeo; Tezuka, Koji; Mizutani, Masaomi; Isobe, Hideki; Hachiya, Osamu; Kimura, Wataru
Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine), 2011/03/31, Letnik: 31, Številka: 3Journal Article
A 31-year-old woman with no basic disease was brought to our hospital by ambulance because with shock due to bleeding after giving birth. Angiography showed bleeding from the left uterine artery, so we coiled the point. A CT scan after the interventional radiology showed uterine rupture and persistent bleeding. We therefore performed an emergency operation to remove the ruptured uterus. Intraoperatively, a segmental ischemic change in small intestine was revealed and we resected approximately 50cm of the nonviable terminal ileum. Histopathological findings revealed no thrombus, and embolization in the main arteries and veins were observed in the excised specimen. We finally diagnosed the patient's condition as non-occlusive mesenteric ischemia. The postoperative course was uneventful. She fully recovered and was discharged 18 days after the operation. We experienced a case of NOMI in a young woman who fell into hemorrhagic shock due to uterine rupture after giving birth. Our findings suggest that we have to take NOMI into consideration when we examine the unstable circulatory dynamics of patients who not only have multiple complications case but are also young.
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