Abstract
A 72-year-old man was admitted to our hospital with the complaint of abdominal pain. CT showed inflammation in the ileocecum and hepatic portal venous gas ; neither intestinal necrosis nor perforation was observed. Therefore, he was admitted to our hospital for conservative treatment. Since his clinical course was satisfactory after admission, he was discharged. However, he returned to visit our hospital one week later with the main complaint of abdominal pain. Since CT showed a small intestinal obstruction starting from the ileocecum, he was readmitted to our hospital. After insertion of an ileus tube to reduce intestinal pressure, he underwent colonoscopy which revealed a longitudinal ulcer and obstruction at the terminal ileum. Upon examination of biopsy samples obtained from the ulcer, he was diagnosed as having Crohn's disease. There have been few reports on elderly-onset Crohn's disease, and hepatic portal venous gas in patients with Crohn's disease is rare.
