A Survived Case of Acute Mesenteric Artery Occlusion with Hepatic Portal Venous Gas

Kazuya Miyoshi, Takeshi Matsui, Junichi Gangi, Toshihiko Waku, Kunzo Orita*

Department of Surgery, Municipal Shuusou Hospital
*First Department of Surgery, Okayama University Medical School

Hepatic portal venous gas is a rare condition due to numerous etiologies, and has been regarded as an ominous prognostic sign. The acute superior mesenteric artery occlusion associated with hepatic portal venous gas has a grave prognosis particularly, only four cases having been recorded as surviving that event. A 64-year-old man with a past history of Buerger's disease was admitted complaining sudden crampy abdominal pain. A plain radiograph showed dilated loops of the small intestine in the right upper quadrant of the abdomen. Computed tomography of the upper abdomen demonstrated peripheral distribution of air in the hepatic portal vein. An emergency laparotomy was performed 13 hours after the onset revealed segmental necrosis of the ileum. Then 40 cm of the ileum was resected, and end-to-end ileoileostomy was performed. The patient made an uneventful recovery.

Key words
hepatic portal venous gas, superior mesenteric artery occlusion

Reprint requests
Kazuya Miyoshi Department of Surgery, Municipal Shuusou Hospital
131 Nyuugawa, Touyo-city, 799-13 JAPAN

Accepted
October 12, 1994

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