To report a case of severe lactic acidosis resulting from non-occlusive mesenteric ischemia (NOMI) and ischemic hepatitis (IH) in an elderly patient.
Approach:
Case Presentation: An 84-year-old man with a history of panvascular disease developed severe lactic acidosis after foot surgery, leading to ICU admission and multidisciplinary management.
Key Findings:
The patient exhibited marked hyperlactatemia with lactate levels exceeding 20 mmol/L.
Imaging revealed extensive atherosclerosis of the abdominal aorta and its branches, mural thrombi, penetrating atherosclerotic ulcers, and ischemic changes in the bowel and right hepatic lobe.
NOMI and IH were diagnosed as complications of splanchnic hypoperfusion.
Interpretation:
NOMI should be considered in elderly patients with panvascular disease presenting with unexplained hyperlactatemia and metabolic acidosis.
Limitations:
The case study is based on a single patient, limiting generalizability.
Lack of long-term follow-up data on the patient's recovery.
Conclusion:
NOMI and ischemic hepatitis are severe complications that require early recognition and multidisciplinary management.
