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September 9, 1974

Diuretic Agents: Inciting Factor in Nonocclusive Mesenteric Infarction?

Author Affiliations

From the Department of Surgery, Harvard Medical School, and the Beth Israel Hospital, Boston.

JAMA. 1974;229(11):1451-1453. doi:10.1001/jama.1974.03230490039020

Mesenteric infarction in the absence of organic vascular occlusion represents the most common and lethal variety of intestinal ischemia. Hemorrhagic shock, decreases in splanchnic perfusion of cardiac origin, and digitalis glycosides have been implicated in the pathogenesis of this entity, but no single causative factor can be identified in a significant number of individuals. Three patients are described in whom massive extracellular volume deficits induced by diuretic therapy initiated the development of nonocclusive mesenteric ischemia. Drastic diuresis should be monitored meticulously in patients with cardiac disease, especially in those taking digitalis or its derivatives.

(JAMA 229:1451-1453, 1974)