Diagnosis and treatment of nonocclusive XXXX after open heart surgery.

@entity1 @entity63 @entity2616 @entity1031 @entity3302 @entity5327
BACKGROUND: Acute nonocclusive @entity5327 (NOMI) is a rare but often fatal event after cardiac surgery. METHODS: Twenty @entity1 with ongoing @entity2616 after cardiac surgery despite maximal laxative treatment underwent selective mesenteric angiography. In cases of pathological radiographic findings, @entity3302 was continuously administered via an intraarterial perfusion catheter. RESULTS: Severe NOMI was confirmed in seven @entity1 (mean lactate: 6.9 +/- 8.3 mg/dL), mild to moderate findings in another seven (mean lactate: 1.4 +/- 1.1 mg/dL). One @entity1 had @entity1031 occlusion of the superior mesenteric artery; five @entity1 demonstrated normal imaging findings. In nine of fourteen @entity1 (64%) treated with @entity3302 , symptoms improved within hours (defecation occurred after 4-29 hours, mean 13 +/- 8.1 hours). No side effects or complications occurred in connection with the @entity3302 treatment. The clinical condition of five @entity1 deteriorated. Four @entity1 underwent laparotomy with creation of an ileostomy or colostomy, two of whom presented with severe @entity63 and later died. One @entity1 died prior to laparotomy. CONCLUSIONS: Selective mesenteric angiography with continuous @entity3302 administration is a simple, fast, and effective diagnostic and therapeutic tool to reduce the need for laparotomy for symptoms of @entity2616 after open-heart surgery.
