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Jean-Marc Dueymes; Isabelle Vernier; Philippe Dumazer; François X. Thierry; Jacques P. Pourrat; Jean J. Conté
Institut National de la Santé et de la Recherche Médicale Toulouse, France

JAMA. 1987;257(9):1177-1178.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Diamond et al¹ report that nonocclusive bowel infarction is a frequent cause of mortality (9%) in dialysis patients. We confirm this finding, having observed 15 similar complications in 13 patients in the last six years.

The physiopathologic mechanisms of nonocclusive bowel infarction remain unknown. Diamond et al suggest the possible role of volume contraction and of splanchnic vasoconstriction induced by drugs like digitalis, vasopressors, or β-blockers. Volume contraction resulting from excessive fluid loss could be demonstrated in ten of 15 episodes that we observed. However, in five cases, neither abnormal fluid loss nor splanchnic vasoconstriction was present.

The first patient was a 25-year-old woman, a dialysis patient for ten years. Diffuse abdominal pain appeared 24 hours after the end of a dialysis session. Cecal necrosis was found at surgery. One year later, similar abdominal pain progressively recurred. Surgery was performed again, disclosing diffuse involvement of the . . . [Full Text PDF of this Article]

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