Case reportDelayed intestinal stenosis of nonocclusive mesenteric ischemia after autologous blood collection: A case report

- The following two points are the subject of this case report. First, autologous blood collection can be a risk factor of nonocclusive mesenteric ischemia (NOMI). Second, delayed intestinal stenosis after the recovery from NOMI may require surgical intervention in some cases. As far as the authors know, there is no report about NOMI associated with autologous blood collection. In addition, there are few reports about delayed intestinal stenosis after the recovery from NOMI. In this respect, we believe that this case is worth reporting.

IntroductionNonocclusive mesenteric ischemia (NOMI) has been reported to be associated with high mortality. Early diagnosis of NOMI and prompt restoration of the intestinal blood flow is necessary in order to achieve a favorable outcome.Presentation of caseWe present the case of a patient who developed NOMI after autologous blood collection and was treated by selective infusion of the superior mesenteric artery with papaverine, intestinal decompression using a long intestinal tube, the administration of antibiotics, and fluid replacement. Although this non-surgical management was successful, 8 weeks after the ischemic event, segmental bowel resection was necessary because of repeated intestinal obstruction caused by bowel stricture.DiscussionAutologous blood collection might be a risk factor of NOMI. In addition, the possibility of delayed intestinal stenosis remains, even if bowel necrosis and surgical resection were avoided with non-surgical management including vasodilator therapy.ConclusionRapid diagnosis and intervention are essential to minimize intestinal ischemia.