Severe Lactic Acidosis Due to Non-occlusive Mesenteric Ischemia and Ischemic Hepatitis: A Case Study

Overview

This case study presents an 84-year-old man who developed severe lactic acidosis due to non-occlusive mesenteric ischemia (NOMI) and ischemic hepatitis (IH) following foot surgery.

Background

Non-occlusive mesenteric ischemia (NOMI) and ischemic hepatitis (IH) are critical conditions that can lead to significant morbidity and mortality, particularly in elderly patients with complex medical histories. The concurrent occurrence of these conditions can exacerbate lactic acidosis, complicating clinical management.

Data Highlights

No numerical data or trial data provided in the article.

Key Findings

• An 84-year-old man with a history of panvascular disease developed severe lactic acidosis post-surgery.
• His lactate levels exceeded 20 mmol/L, indicating severe metabolic acidosis.
• Contrast-enhanced CT revealed extensive atherosclerosis and ischemic changes in the bowel and liver.
• The patient was diagnosed with NOMI complicated by IH.
• Intensive care measures led to stabilization and successful discharge of the patient.
• Early recognition of NOMI is crucial in elderly patients presenting with unexplained hyperlactatemia.

Clinical Implications

Clinicians should maintain a high index of suspicion for NOMI in elderly patients with perioperative volume fluctuations and unexplained metabolic acidosis.

Conclusion

This case highlights the recognition of NOMI and IH in critically ill patients, particularly those with complex medical histories.

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