Abstract
We experienced a transient intestinal ischemia which appeared to be abdominal angina. A 64-year-old man was seen at the hospital because of upper abdominal pain suddenly occurred during drinking. The abdominal pain was intensified, and melena and shock developed. The patient presented significant acidosis, as shown by pH 7.184, BE-17.9mEq/l, and HCO-3 8.5mEq/1 in an arterial blood gas analysis. Conservative treatment successfully improved the abdominal pain and gas analysis values were also improved: pH 7.548, BE 8.0mEq/l, and HCO-3 29.3mEq/l. However, a possibility of strangulated ileus could not be denied, and laparotomy was performed. There was 1, 850ml of white puruloid ascites in the abdominal cavity and the entire small intestine coloured dark red brown and lapsed into ischemia. To confirm the cause of the ischemia, the small intestine was dragged out of the surgical wound, and pulsation was confirmed at the artery of intestinal verge presenting as ischemia. Lavage of the small intestine with warmed saline was done, and discolored small intestine was gradually normalized. The small intestine was not excised and the wound was closed. Postoperatively, paroxysmal abdominal pain occurred with after meals, but was alleviated by isosorbide nitrate tape preparation. He has been well, as of one year and 5 months after the operation.
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