Portomesenteric venous gas: A late complication of pneumatosis intestinalis. (2015)

• Record Type: Journal Article
• Authors: Faraj, W.; Srinivasan, P.; El Nounou, G.; Abou El Naaj, A.; Khalife, M.; Doughan, Samer; Haydar, A.
• Is Part Of: International journal of surgery case reports. Volume 6(2015)
• Page Start: 244
• Page End: 246
• Publication Date: 2015
• Subjects: Pneumatosis intestinalis -- Portomesenteric -- Venous gas; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2014.10.053
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Radiology is important to detect gas presence in the portal venous system and PI. Gas presence in the portal venous system and PI in adults indicates severe disease. It requires early surgical intervention in patients with suspected bowel ischaemia. Early surgical intervention in the presence of gas may avoid significant mortality. Abstract: Background: The pneumatosis intestinalis is an entity with multiple aetiologies and may be associated with a fatal outcome when present on plain radiographs. When associated with the presence of portomesenteric venous gas (PMVG) it is typically the result of bowel ischaemia. Methods and results: We are presenting a case of a 43 year old male who presented with a two days history of haematemesis, generalised abdominal pain and distension. Computed tomography (CT) scan revealed a gross amount of air within the portal venous system and small bowel dilatation to the level of distal ileum was also seen with associated pneumatosis intestinalis. Emergency laparotomy was conducted which demonstrated a simple band adhesion resulting in bowel ischaemia. The patient was making a good post-operative recovery complicated only by sub-therapeutic treatment of schizophrenia. Conclusion: The presence of gas within the portal venous system and PI in adults can indicate severe life-threatening disease. This requires early surgical intervention in those patients with a clinical suspicion of bowel ischaemia, and with radiological signs. This may avoid significant mortality.