2020 Volume 34 Issue 3 Pages 96-100
Portal venous gas (PVG) and pneumatosis intestinalis (PI) are considered rare findings, and are associated with a poor prognosis. The most common underlying pathology is bowel necrosis. Cases of PVG and PI due to trauma have been reported ; however, the delayed appearance of PVG and PI in a blunt trauma patient has yet to be reported. The patient was a man in his 70s who had been hit by a car. As consciousness disturbance and shock were observed at the scene, he was transported to our hospital. He sustained traumatic brain injury. Conservative management was initiated and his consciousness level improved. However, his vital signs became unstable on hospital day 4 and CT was performed, which revealed PVG and PI. Emergency laparotomy, which was performed for suspected bowel necrosis, revealed no bowel necrosis. Postoperative management included broad-spectrum antibiotics and polymyxin B-immobilized fiber column direct hemoperfusion. The postoperative course was uneventful. The patient was transferred to another hospital on hospital day 41.
