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Rare disease
CASE REPORT
Non-occlusive mesenteric ischaemia associated with anorexia nervosa
  1. Takashi Sakamoto1,
  2. Alan Kawarai Lefor2 and
  3. Tadao Kubota1
  1. 1 Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
  2. 2 Department of Surgery, Jichi Medical University, Shimotsuke, Japan
  1. Correspondence to Dr Takashi Sakamoto, takac93{at}gmail.com

Abstract

Non-occlusive mesenteric ischaemia (NOMI) is a life-threatening condition that requires emergent intervention and anorexia nervosa is a chronic eating disorder that requires careful medical and nutritional management. A 54-year-old woman with a history of anorexia nervosa and undergoing chronic haemodialysis developed abdominal pain and called an ambulance. On arrival, she was in shock and abdominal examination was consistent with diffuse peritonitis. Computed tomography scan suggested ischaemia from the distal ileum to the ascending colon. Emergency laparotomy revealed NOMI from the distal ileum to the transverse colon. The treatment strategy included staged operations and careful medical management to optimise nutritional support and electrolyte management with survival of the patient. NOMI and anorexia nervosa are both difficult to manage. Meticulous interdisciplinary management can result in a good outcome.

  • nutritional support
  • eating disorders
  • gastrointestinal surgery
  • general surgery

https://doi.org/10.1136/bcr-2019-229703

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    Footnotes

    • Contributors TS contributed to the conception, the acquisition, interpretation of data, drafting the work and revising it critically for important intellectual content. AKL and TK contributed to the conception, interpretation of data and revising the draft critically for important intellectual content. All authors approved final version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.