Successful management of extensive bowel resection without intestinal continuity: a case report
Patients with intestinal ischemia associated with acute aortic dissection often require emergent bowel resection, which results in serious complications. We present a case of successful surgical management of extensive bowel necrosis caused by acute aortic dissection. A 42-year-old man underwent eme...
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| Veröffentlicht in: | Nagoya journal of medical science 2019-11, Vol.81 (4), p.711-716 |
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| container_title | Nagoya journal of medical science |
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| creator | Mohri, Koichi Takeuchi, Eiji Miyake, Hideo Nagai, Hidemasa Yoshioka, Yuichiro Okuno, Masataka Yuasa, Norihiro |
| description | Patients with intestinal ischemia associated with acute aortic dissection often require emergent bowel resection, which results in serious complications. We present a case of successful surgical management of extensive bowel necrosis caused by acute aortic dissection. A 42-year-old man underwent emergent subtotal resection of the small intestine, right colectomy, tube gastrostomy, and transverse colostomy; however, intestinal continuity was not restored. He developed two major postoperative complications: unconsciousness due to metabolic alkalosis caused by massive discharge from the gastrostomy and jaundice due to bile salt depletion caused by disruption of the enterohepatic circulation. His serum bilirubin levels decreased after the infusion of gastric discharge through gastrostomy into the transverse colon through the colostomy; thereafter, a second operation was performed to restore gastrointestinal continuity. Overall, patients undergoing massive bowel resection without intestinal continuity require careful management of electrolytes and bile salt. |
| doi_str_mv | 10.18999/nagjms.81.4.711 |
| format | Article |
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We present a case of successful surgical management of extensive bowel necrosis caused by acute aortic dissection. A 42-year-old man underwent emergent subtotal resection of the small intestine, right colectomy, tube gastrostomy, and transverse colostomy; however, intestinal continuity was not restored. He developed two major postoperative complications: unconsciousness due to metabolic alkalosis caused by massive discharge from the gastrostomy and jaundice due to bile salt depletion caused by disruption of the enterohepatic circulation. His serum bilirubin levels decreased after the infusion of gastric discharge through gastrostomy into the transverse colon through the colostomy; thereafter, a second operation was performed to restore gastrointestinal continuity. 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We present a case of successful surgical management of extensive bowel necrosis caused by acute aortic dissection. A 42-year-old man underwent emergent subtotal resection of the small intestine, right colectomy, tube gastrostomy, and transverse colostomy; however, intestinal continuity was not restored. He developed two major postoperative complications: unconsciousness due to metabolic alkalosis caused by massive discharge from the gastrostomy and jaundice due to bile salt depletion caused by disruption of the enterohepatic circulation. His serum bilirubin levels decreased after the infusion of gastric discharge through gastrostomy into the transverse colon through the colostomy; thereafter, a second operation was performed to restore gastrointestinal continuity. Overall, patients undergoing massive bowel resection without intestinal continuity require careful management of electrolytes and bile salt.</description><subject>Adult</subject><subject>Aneurysm, Dissecting</subject><subject>Case Report</subject><subject>Colostomy</subject><subject>Humans</subject><subject>Intestinal Obstruction</subject><subject>Intestines - pathology</subject><subject>Intestines - surgery</subject><subject>Male</subject><subject>Postoperative Complications</subject><issn>0027-7622</issn><issn>2186-3326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkEtPwzAQhC0EoqVw54T8B1L8SBybAxKqeEmVOADnaJOsW1eJU8VOS_89kXgITrvSzHzaWUIuOZtzbYy59rDatGGu-Tyd55wfkangWiVSCnVMpoyJPMmVEBNyFsKGsdQYZk7JRHKdGmnYlBSvQ1VhCHZoaAsjDlv0kXaW4kdEH9wOadntsaE9Bqyi6zzdu7juhkidjxii89DQqvPjMrh4uKFAKwg4-rddH8_JiYUm4MX3nJH3h_u3xVOyfHl8Xtwtk40UMiY8h_HmzIJhtc11mkEtkGlWgwSeAee6lFZKKHkmOC8z0KVIbYkMpWBWVXJGbr-426Fssa7GEj00xbZ3LfSHogNX_Fe8WxerblcobYRSagRc_QX8Jn9eJT8BIIBwUA</recordid><startdate>20191101</startdate><enddate>20191101</enddate><creator>Mohri, Koichi</creator><creator>Takeuchi, Eiji</creator><creator>Miyake, Hideo</creator><creator>Nagai, Hidemasa</creator><creator>Yoshioka, Yuichiro</creator><creator>Okuno, Masataka</creator><creator>Yuasa, Norihiro</creator><general>Nagoya University</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>5PM</scope></search><sort><creationdate>20191101</creationdate><title>Successful management of extensive bowel resection without intestinal continuity: a case report</title><author>Mohri, Koichi ; Takeuchi, Eiji ; Miyake, Hideo ; Nagai, Hidemasa ; Yoshioka, Yuichiro ; Okuno, Masataka ; Yuasa, Norihiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-j323t-17a3325fa90df7845ad2e080da3a15a118b3f33ab15211b5a8b24fbe0e320f6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aneurysm, Dissecting</topic><topic>Case Report</topic><topic>Colostomy</topic><topic>Humans</topic><topic>Intestinal Obstruction</topic><topic>Intestines - pathology</topic><topic>Intestines - surgery</topic><topic>Male</topic><topic>Postoperative Complications</topic><toplevel>online_resources</toplevel><creatorcontrib>Mohri, Koichi</creatorcontrib><creatorcontrib>Takeuchi, Eiji</creatorcontrib><creatorcontrib>Miyake, Hideo</creatorcontrib><creatorcontrib>Nagai, Hidemasa</creatorcontrib><creatorcontrib>Yoshioka, Yuichiro</creatorcontrib><creatorcontrib>Okuno, Masataka</creatorcontrib><creatorcontrib>Yuasa, Norihiro</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Nagoya journal of medical science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mohri, Koichi</au><au>Takeuchi, Eiji</au><au>Miyake, Hideo</au><au>Nagai, Hidemasa</au><au>Yoshioka, Yuichiro</au><au>Okuno, Masataka</au><au>Yuasa, Norihiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Successful management of extensive bowel resection without intestinal continuity: a case report</atitle><jtitle>Nagoya journal of medical science</jtitle><addtitle>Nagoya J Med Sci</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>81</volume><issue>4</issue><spage>711</spage><epage>716</epage><pages>711-716</pages><issn>0027-7622</issn><eissn>2186-3326</eissn><abstract>Patients with intestinal ischemia associated with acute aortic dissection often require emergent bowel resection, which results in serious complications. We present a case of successful surgical management of extensive bowel necrosis caused by acute aortic dissection. A 42-year-old man underwent emergent subtotal resection of the small intestine, right colectomy, tube gastrostomy, and transverse colostomy; however, intestinal continuity was not restored. He developed two major postoperative complications: unconsciousness due to metabolic alkalosis caused by massive discharge from the gastrostomy and jaundice due to bile salt depletion caused by disruption of the enterohepatic circulation. His serum bilirubin levels decreased after the infusion of gastric discharge through gastrostomy into the transverse colon through the colostomy; thereafter, a second operation was performed to restore gastrointestinal continuity. 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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Open Access Titles of Japan; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Aneurysm, Dissecting Case Report Colostomy Humans Intestinal Obstruction Intestines - pathology Intestines - surgery Male Postoperative Complications |
| title | Successful management of extensive bowel resection without intestinal continuity: a case report |
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