Mesenterialinfarkt - eine schwerwiegende Komplikation bei Schwerbrandverletzten

Abstract

Gastrointestinal complications are a common problem in severe burned patients. Reported complications include paralytic ileus, gastrointestinal tract bleeding, gastric ulcers and acute necrotizing cholecystitis. Although there are no exact data concerning the frequency and outcome of acute intestinal necrotizing ischemia in severe burned patients, it is a well known complication in specialized burn centers. The most common reason for acute intestinal ischemia are arterial embolism, arterial thrombosis, venous thrombosis and non-occlusive disease. The overall survival differs between 81 % and 34 %. The therapy aims at arterial re-perfusion of life-threatening intestinal regions and resection of necrotic tissue. A 45-year-old male patient attempted suicide by inflaming himself with gasoline. He sustained partial and full thickness burn injury of the face and the throat. Additional burn injuries were found at the chest region, both arms and the abdominal wall. The total burn surface area (TBSA) was 42 % including an severe inhalation injury trauma. The ABSI-score (Abbreviated burn severity index) was 10. The combination of a thrombus at the aortic valve with an tachycardic dysrhythmia was the cause for an embolisation with acute intestinal ischemia. The necrotic part of the small intestine was resected, the further course was uncomplicated.