Case report: Early detection of mesenteric ischemia by intravital microscopy in a patient with septic shock

Janina Praxenthaler; Janina Praxenthaler; Carmen Kirchner; Elke Schwier; Simon Altmann; Simon Altmann; Axel Wittmer; Dietrich Henzler; Thomas Köhler; Thomas Köhler

doi:10.3389/fmed.2022.985977

Frontiers in Medicine (Aug 2022)

Case report: Early detection of mesenteric ischemia by intravital microscopy in a patient with septic shock

Janina Praxenthaler,
Janina Praxenthaler,
Carmen Kirchner,
Elke Schwier,
Simon Altmann,
Simon Altmann,
Axel Wittmer,
Dietrich Henzler,
Thomas Köhler,
Thomas Köhler

Affiliations

Janina Praxenthaler: Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Ruhr University Bochum, Herford, Germany
Janina Praxenthaler: Department of Anesthesiology, Intensive Care and Pain Medicine, Kliniken Südostbayern, Klinikum Traunstein, Traunstein, Germany
Carmen Kirchner: Department of General and Visceral Surgery, Thoracic Surgery and Proctology, Klinikum Herford, Ruhr University Bochum, Herford, Germany
Elke Schwier: Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Ruhr University Bochum, Herford, Germany
Simon Altmann: Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Ruhr University Bochum, Herford, Germany
Simon Altmann: Department of Anesthesiology, Intensive Care and Pain Medicine, Knappschaftskrankenhaus Bochum, Ruhr University Bochum, Bochum, Germany
Axel Wittmer: Institute of Pathology, Klinikum Herford, Herford, Germany
Dietrich Henzler: Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Ruhr University Bochum, Herford, Germany
Thomas Köhler: Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Ruhr University Bochum, Herford, Germany
Thomas Köhler: Department of Anesthesiology and Intensive Care Medicine, AMEOS-Klinikum Halberstadt, Halberstadt, Germany

DOI: https://doi.org/10.3389/fmed.2022.985977
Journal volume & issue: Vol. 9

Abstract

Read online

Gut ischemia is a frequent but underdiagnosed complication, especially in critically ill intensive care patients, and represents a special diagnostic challenge that can only be solved in an interdisciplinary manner. We report a case of a 54-year-old woman with acute mesenteric ischemia (AMI) as a cause of septic shock diagnosed by intravital microscopy (IVM) 2 days before visible necrotic changes in a multimodality approach. We show that intravital microscopy can be a serious alternative for the early diagnosis of mesenteric ischemia in the hands of the skilled. We use this case to discuss the value and clinical perspective of IVM in the intensive care setting.

Published in Frontiers in Medicine

ISSN: 2296-858X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Medicine (General)
Website: http://www.frontiersin.org/journals/medicine

About the journal

Abstract

Keywords