1999 Volume 32 Issue 5 Pages 1227-1230
Hepatic portal venous gas occurs in a variety of digestive diseases, and demonstrates a poor prognosis. A successfully treated case of pneumatosis coli with hepatic portal venous gas is reported. A 75-year-old woman was admitted to our hospital complaining of a sudden onset of abdominal pain. Abdominal CT showed dilated peripheral distribution of air in the hepatic portal vein and emphysema in the wall of the caecum, ascending colon and transverse colon. We made a diagnosis of pneumatosis coli with hepatic portal venous gas. Due to an increase in abdominal pain, an emergent laparotomy was performed 12 hours after onset. Pneumotosis was detected in the wall of the caecum, ascending colon and transverse colon. Right hemicolectomy with ileostomy and transverse colostomy were performed. After an uneventful recovery from surgery, closure of the ileostomy and transverse colostomy was performed with side-to-side, ileo-transverse colostomy. The postoperative course was uneventful and the patient was discharged on the 79th day after initial surgery.
