A Case of Pneumatosis Coli with Hepatic Portal Venous Gas

Tetsunobu Udaka^{1) 2)}, Kenzo Hori¹⁾, Takashi Andou¹⁾, Kazuhiro Tsuji¹⁾,Hidenobu Mitani¹⁾, Masaomi Yamane¹⁾ and Mikage Hamazaki³⁾

¹⁾ Department of Surgery, Gastroenterological Center, Yashima General Hospital, ²⁾ Department of Surgery, Mitoyo General Hospital, ³⁾ Department of Pathology, Mitoyo General Hospital

Hepatic portal venous gas occurs in a variety of digestive diseases, and demonstrates a poor prognosis. A successfully treated case of pneumatosis coli with hepatic portal venous gas is reported. A 75-year-old woman was admitted to our hospital complaining of a sudden onset of abdominal pain. Abdominal CT showed dilated peripheral distribution of air in the hepatic portal vein and emphysema in the wall of the caecum, ascending colon and transverse colon. We made a diagnosis of pneumatosis coli with hepatic portal venous gas. Due to an increase in abdominal pain, an emergent laparotomy was performed 12 hours after onset. Pneumotosis was detected in the wall of the caecum, ascending colon and transverse colon. Right hemicolectomy with ileostomy and transverse colostomy were performed. After an uneventful recovery from surgery, closure of the ileostomy and transverse colostomy was performed with side-to-side, ileo-transverse colostomy. The postoperative course was uneventful and the patient was discharged on the 79th day after initial surgery.

Key words
pneumatosis coli, hepatic portal venous gas

Reprint requests
Tetsunobu Udaka Department of Surgery, Mitoyo General Hospital 708 Himehama, Toyohama-cho, Mitoyo-gun, Kagawa, 769-1695 JAPAN

Accepted
December 9, 1998

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