Abstract
A 70-year-old male was admitted to our hospital with gastric ulcers. We treated this patient conservatively and he showed improvement of the gastric ulcers. The night after starting enteral feeding, he complained of fever, bloody diarrhea with mucus and a decreased urine volume. A non-contrast abdominal CT image showed hepatic portal venous gas (HPVG) the next day. There were no signs of peritonitis on physical examination. Therefore, conservative treatment was provided. A contrast abdominal CT was repeated 6 hours later and showed nearly complete disappearance of HPVG. In addition, no definite evidence of bowel necrosis or ischemia was seen. We monitored the patient closely with a reduced threshold for surgical correction under appropriate conditions in the ICU, and conservative management was continued. Subsequently, his general condition improved, and he was transferred back to the ward on the 4th ICU day. On admission, blood cultures revealed Acinetobacter baumannii. There was no culture revealed A. baumannii without blood. The final diagnosis was bacterial translocation (BT). HPVG had complicated with BT in this case.
