Abstract
An 81-year-old female with diabetes, cerebral infarction, rheumatoid arthritis was admitted to our institation because of diarrhea, hematochezia, and shock. Abdominal ultrasonography demonstrated multiple high-echoic structures in the liver and portal vein. Computed tomogra-phy revealed multiple gas shadows in the portal system and a thickened wall of the small intestine in the pelvis. Blood examination revealed metabolic acidosis and disseminated intravascular coagulation (DIC). Initially diagnosis of hepatic portal venous gas (HPVG) with non-obstructive mesenteric ischemia was made. Endoscopy on 27th hospital day revealed longitudinal, deep, annular ulcers and pseudomenbranous erosions of the sigmoid colon to upper rectum. Biopsied specimen revealed giant cells with including body and CMV-antigenemia was positive. Outcome was favorable after infusion of ganciclovir in addition to intensive treat-ment. A case reported of CMV-colitis with HPVG was rare.
