Abstract
A 60-year-old man was admitted due to abdominal pain and high fever. His white blood cell count and C-reactive protein were 17,000/μl and 25.93 mg/dl, respectively. Computed tomography (CT) visualized hepatic portal venous gas and diverticulitis of the sigmoid colon. We suspected a perforation of the sigmoid colon and an emergency operation was performed under the diagnosis of severe diverticulitis with hepatic portal venous gas. We found the sigmoid colon became a red induration. There was no turbid ascites in the abdominal cavity but we found gastro-intestinal penetration into the mesentery, so we performed a sigmoidectomy. Intraoperative findings revealed anastomotic insufficiency and a colostomy of the transverse colon was performed. After the second operation, he made a good recovery.
Hepatic portal venous gas is considered to be a poor prognostic condition requiring emergency laparotomy ; but recently, many cases have been reported to recover spontaneously without surgical intervention. We report a case of diverticulitis of the sigmoid colon with hepatic portal venous gas, including a discussion of the literature.
