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Use of indocyanine green fluorescence imaging to determine the area of bowel resection in non-occlusive mesenteric ischemia: A case report.
Nakagawa, Yutaka; Kobayashi, Kazuaki; Kuwabara, Shirou; Shibuya, Hiroyuki; Nishimaki, Tadashi.
Afiliación
  • Nakagawa Y; Department of Digestive Surgery, Niigata City General Hospital, Japan. Electronic address: y.nakagawa.323@gmail.com.
  • Kobayashi K; Department of Digestive Surgery, Niigata City General Hospital, Japan.
  • Kuwabara S; Department of Digestive Surgery, Niigata City General Hospital, Japan.
  • Shibuya H; Department of Pathology, Niigata City General Hospital, Japan.
  • Nishimaki T; Department of Digestive and General Surgery, Graduate School of Medicine, University of Ryukyus, Japan.
Int J Surg Case Rep ; 51: 352-357, 2018.
Article en En | MEDLINE | ID: mdl-30248629
INTRODUCTION: Non-occlusive mesenteric ischemia (NOMI) is a type of acute intestinal ischemia, and its associated mortality is very high. In laparotomy of NOMI, we often have difficulty determining the area of bowel resection. We herein describe a case in which we detected the area of bowel resection using indocyanine green (ICG) fluorescence imaging. PRESENTATION OF THE CASE: An 89-year-old man diagnosed as having advanced gastric cancer underwent distal gastrectomy. On the night of postoperative day 4, he strongly complained of distention of the abdomen. The laboratory data indicated severe metabolic acidosis and dehydration. The abdominal computed tomography scan showed a dilated small bowel, but there were no specific signs suggestive of bowel necrosis. We suspected NOMI and decided to perform emergency laparotomy because we could not exclude the possibility of bowel necrosis. During the operation, we could not detect the necrotic bowel macroscopically. After injecting 2.5 mg of ICG, the ischemic area of the bowel became visible as a region with poor fluorescence emission using the Photodynamic Eye™ (Hamamatsu Photonics K.K.). We resected the ischemic bowel and performed anastomosis. We confirmed that he was alive at 4 months after the operation of NOMI. CONCLUSION: Intraoperative ICG fluorescence imaging makes it possible to detect necrotic intestine that cannot be found with the naked eye. By using this method, planned reoperation to find any newly developed necrotic intestine might be unnecessary. Intraoperative ICG fluorescence imaging is useful for defining the area of ischemic bowel in a patient with NOMI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Int J Surg Case Rep Año: 2018 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Int J Surg Case Rep Año: 2018 Tipo del documento: Article Pais de publicación: Países Bajos