A CASE OF CROHN'S DISEASE THAT SHOWED HEPATIC PORTAL VENOUS GAS AND PERFORATION OF SMALL INTESTINE AT THE TIME OF BALLOON-ASSISTED ENTEROSCOPY

Abstract

The patient was an approximately 30-year-old man with Crohn's disease. He was in clinical remission after receiving Infliximab. To evaluate the mucosal lesion, trans-anal double-balloon endoscopy was performed. The ileum was stenotic, and the endoscope could not pass through. Because mucosal healing was achieved, we attempted to perform endoscopic retrograde ileography. During the ileography, contrast media leaked to the abdominal space and the appearance of hepatic portal venous gas was observed. For the intestinal perforation, partial ileal resection was performed by emergency operation. The hepatic portal venous gas disappeared in the natural course without any special treatment. We report a case of Crohn's disease in which intestinal perforation occurred and hepatic portal venous gas appeared during double-balloon endoscopy and retrograde ileography.