Abstract
A 70-year-old man underwent tumorectomy, partial resection of the small intestine, gastrostomy and enterostomy for a mesenchymal liposarcoma. Although hepatic portal venous gas (HPVG) and pneumatosis intestinalis (PI) were identified on postoperative day (POD) 6, conservative management was selected because the general condition of the patient was stable. However, HPVG and PI with massive ascites developed again with septic shock. An exploratory laparotomy was performed under the suspicion of intestinal necrosis, but no definitive necrosis was revealed. PI again occurred on POD 34, and HPVG and acute cholecystitis were identified on POD 80, with conservative managements proving effective for both episodes. The patient was discharged on POD 117. HPVG and PI have been considered to warrant an emergency operation, but if the general condition of the patient is stable, conservative management is possible.
