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EHS

[A Case of Suspected Non-Occlusive Mesenteric Ischemia following Neoadjuvant Chemotherapy for Esophageal Cancer with an Extremely Poor Prognosis]


Non-occlusive mesenteric ischemia(NOMI)is defined as intestinal ischemia or necrosis with patency of the mesenteric arteries. Here, we report a case of suspected NOMI following neoadjuvant chemotherapy for esophageal cancer with an extremely poor prognosis. A 79-year-old man complained of weight loss and vomiting. Esophagogastroduodenoscopy revealed a tumor extending from the lower intrathoracic esophagus to the gastric cardia. He was diagnosed with esophageal cancer(small cell neuroendocrine carcinoma, T3(AD)N0M0, cStage Ⅱ)accordingly. He received cisplatin and etoposide as neoadjuvant chemotherapy. Tube feeding was initiated due to tumor stenosis. His weight increased rapidly by more than 8 kg on the second day of treatment. He did not display any signs of heart failure, and so continued chemotherapy in conjunction with diuretics. Upon completion of chemotherapy, his continued use of diuretics gradually reduced his weight. On day 7, the patient complained of nausea and experienced a decrease in blood pressure. Bicarbonate Ringer’s solution was administered intravenously, but the patient lost consciousness after 3 hours. Plain computed tomography revealed massive gas collections in the portal vein, tumor wall, stomach, and ascending colon. NOMI was strongly suspected. His condition continued to deteriorate, until his demise several hours later. Here, we present the above-mentioned case and discuss the relevant literature.



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