Journal
SURGERY TODAY
Volume 44, Issue 2, Pages 359-362Publisher
SPRINGER
DOI: 10.1007/s00595-013-0503-y
Keywords
Non-occlusive mesenteric ischemia; Indocyanine green; Fluorescence; HyperEye Medical System
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Funding
- Grants-in-Aid for Scientific Research [23300191] Funding Source: KAKEN
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Non-occlusive mesenteric ischemia (NOMI), leading to intestinal gangrene without a demonstrable occlusion in the mesenteric artery, is a rare condition with extremely high mortality. We report a case of NOMI diagnosed preoperatively by computed tomography and treated successfully with surgery, assisted by indocyanine green (ICG) fluorescence in the HyperEye Medical System (HEMS), a new device that can simultaneously detect color and near-infrared rays under room light. This allowed for precise intraoperative evaluation of the mesenteric and bowel circulation. Although the necrotic bowel wall of the distal ileum and the segmental ischemia of the jejunum were visible, the jejunum was finally preserved because perfusion of ICG fluorescence was confirmed. The patient, an 84-year-old man, had an uneventful postoperative course and is alive without critical illness 8 months after surgery. We report this case to demonstrate the potential effectiveness of HEMS during surgery for NOMI.
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