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. 2022 Jul 18;4(3):CASE22199. doi: 10.3171/CASE22199

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CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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FIG. 4. — Case 7. Intraoperative findings at the laparotomy. Edema and partial necrosis of the bowel wall is present (white arrows, A). The resected small intestine shows hemorrhagic necrosis (white arrows, B). Pathological examination revealed infiltration of many inflammatory cells into all layers and advanced edema of the submucosa on the luminal surface (C; hematoxylin and eosin, original magnification ×40). Pathological examination of the intestinal specimen showed ghostlike appearance of crypt (black arrows, D) characterized in the borderline region by destroyed mucosal epithelium and necrosis (hematoxylin and eosin, original magnification ×40). No thrombus is observed in the mesenteric vessels (black arrows, E; hematoxylin and eosin, original magnification ×40). Selective SMA angiogram showing narrowing of all SMA branches and poor blood flow (black arrows, F). SMA angiogram showing radiological improvement of severe NOMI after intramesenteric papaverine treatment (black arrows, G).