MIRACULUS OUTCOME OF NON-OCCLUSIVE MESENTRIC ISCHAEMIA (NOMI) IN CARDIOGENIC SHOCK- A CASE REPORT

Abstract

Introduction: Non-occlusive mesenteric ischemia (NOMI) is an acute mesenteric circulatory disorder which includes all types of mesenteric ischemia without any blockage of blood vessels. It is usually seen in elderly age group with risk factors of previous myocardial infarction, congestive cardiac failure and post-cardiac surgery, renal disease, vasopressor use, aortic insufciency. NOMI is an infrequent cause of acute mesenteric ischemia with atypical symptoms & constitutes 20-30% cases of acute mesenteric ischemia (AMI). The mortality rate is generally high, at least 50%, being the deadliest type of acute mesenteric ischemia (AMI). A high index of suspicion is required. Treatment is based on correction of the underlying cause, supportive therapy, vasodilation and surgery. Presenting a challenging case of an elderly patient with Diabetes Mellitus for 15 years in cardiogenic shock with NOMI. Colonoscopy was diagnostic of ischemic colitis. Patient was managed conservatively with successful outcome NOMI is a rare disease with a difcult d Conclusion: iagnosis because of the unspecic symptomatology. Early recognition with high suspicion of index is necessary. Case highlights the challenges in the diagnosis and the multiple difculties during management. Treatment with supportive therapy, vasodilator drugs and surgery if needed can signicantly improve prognosis & lower mortality