Abstract
Localized complications in colonof iberscopy, such as bleeding, perforation, etc, have been well recognized. Recently, we had a rare case of portal venous gas that occured during intra operative colonoscopy. A 27-year-old female with a three year history of ulcerative colitis was admitted to Wakayama Medical College Hospital complaining of abdominal pain, bloody stool and fever of one month duration. She underwent medical therapy consisting of antibiotics, corticosteroid and salicylazosuf apyrindine for five weeks. Following these treatments she was taken to surgery. Under general anesthesia laparotomy was performed and colonof iberscope (Olympus, type TCF) was inserted to clarify the extension of the lesion. Suddenly numberless air bubbles were noticed in all inferior mesenteric venous system. These bubbles appeared to originate from the distended colon and collect toward the portal vein. Her blood pressure dropped to 70/40. She recovered herself under the pertinent treatment by the anesthetist. Fifteen minutes after this happening, the operation proceeded. She had subtotal colectomy and ileorectal anastomsis. Her postoperative course was eventful, and complicated by anastomotic leakage, but she recovered and was discharged on her 139 postoperative day. The etiology of portal venous gas in this case was discussed.
