Non-occlusive disease

Non-occlusive disease
Non-occlusive disease
Other names	Non-occlusive mesenteric ischaemia
Specialty	General surgery, vascular surgery

Non-occlusive disease (NOD) or Non-occlusive mesenteric ischaemia (NOMI) is a life-threatening condition including all types of mesenteric ischemia without mesenteric obstruction. It affects mainly elderly patients above 50 years of age who suffer from cardiovascular disease (myocardial infarction, congestive heart failure or aortic regurgitation), hepatic, chronic kidney disease or diabetes mellitus. It can be triggered also by a previous cardiac surgery with a consequent heart shock.[1][2] It represents around 20% of cases of acute mesenteric ischaemia.[3]

Pathophysiology

Non-occlusive mesenteric ischemia occurs due to severe vasoconstriction of mesenteric vessels supplying the intestine. Acute abdominal pain is the only early acute symptom in those patients, which makes early diagnosis difficult.

Diagnosis

CT angiography would be helpful in differentiating occlusive from non-occlusive causes of mesenteric ischaemia.[4]

Prognosis

Non-occlusive disease has a poor prognosis with survival rate between 40-50%.[1][3]

References

Krämer, S. C.; Görich, J.; Oertel, F.; Scheld, H.; Heindel, W. (1 September 2003). "[Non-occlusive mesenteric ischemia]". RöFo. 175 (9): 1177–1183. doi:10.1055/s-2003-41923. PMID 12964071.
Trompeter, Markus; Brazda, Thurid; Remy, Christopher T.; Vestring, Thomas; Reimer, Peter (1 May 2002). "Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy". Eur Radiol. 12 (5): 1179–1187. doi:10.1007/s00330-001-1220-2. PMID 11976865. S2CID 19135271.
Longmore, Murray; Wilkinson, Ian; Baldwin, Andrew; Wallin, Elizabeth (31 March 2017). Oxford Handbook of Clinical Medicine. OUP Oxford. ISBN 9780199609628 – via Google Books.
Garden, O. James; Bradbury, Andrew W.; Forsythe, John L. R.; Parks, Rowan W. (28 May 2012). Principles and Practice of Surgery E-Book: With STUDENT CONSULT Online Access. Elsevier Health Sciences. ISBN 978-0702051166 – via Google Books.

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[ref1-1] Krämer, S. C.; Görich, J.; Oertel, F.; Scheld, H.; Heindel, W. (1 September 2003). "[Non-occlusive mesenteric ischemia]". RöFo. 175 (9): 1177–1183. doi:10.1055/s-2003-41923. PMID 12964071.

[2] Trompeter, Markus; Brazda, Thurid; Remy, Christopher T.; Vestring, Thomas; Reimer, Peter (1 May 2002). "Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy". Eur Radiol. 12 (5): 1179–1187. doi:10.1007/s00330-001-1220-2. PMID 11976865. S2CID 19135271.

[ref2-3] Longmore, Murray; Wilkinson, Ian; Baldwin, Andrew; Wallin, Elizabeth (31 March 2017). Oxford Handbook of Clinical Medicine. OUP Oxford. ISBN 9780199609628 – via Google Books.

[4] Garden, O. James; Bradbury, Andrew W.; Forsythe, John L. R.; Parks, Rowan W. (28 May 2012). Principles and Practice of Surgery E-Book: With STUDENT CONSULT Online Access. Elsevier Health Sciences. ISBN 978-0702051166 – via Google Books.