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Portomesenteric venous gas: A late complication of pneumatosis intestinalis

W Faraj1, P Srinivasan2, G El Nounou1

  • 1American University of Beirut-Medical Center, Department of Surgery, HBP and Liver Transplant Unit, American University of Beirut-Medical Center, Beirut, Lebanon.

International Journal of Surgery Case Reports
|December 30, 2014
PubMed
Abstract

Insights

Pneumatosis intestinalis with portomesenteric venous gas (PMVG) can signal critical bowel ischemia. Prompt surgical intervention for suspected cases, guided by imaging, can significantly reduce mortality.

Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Radiology

Background:

  • Pneumatosis intestinalis (PI) has diverse causes and can be fatal, especially when accompanied by portomesenteric venous gas (PMVG).
  • PMVG in conjunction with PI often indicates bowel ischemia, a serious condition requiring urgent attention.

Purpose of the Study:

  • To present a case of pneumatosis intestinalis and portomesenteric venous gas.
  • To highlight the diagnostic and therapeutic implications of these findings.

Main Methods:

  • Case report of a 43-year-old male with hematemesis, abdominal pain, and distension.
  • Computed tomography (CT) scan revealed extensive PMVG and pneumatosis intestinalis.
  • Emergency laparotomy identified a band adhesion causing bowel ischemia.

Main Results:

  • The patient underwent successful surgical intervention for bowel ischemia.
  • Post-operative recovery was good, with no complications related to the surgical procedure.
  • The underlying cause was a simple band adhesion.

Conclusions:

  • The combination of PMVG and PI in adults suggests severe, life-threatening disease.
  • Early surgical intervention is crucial for patients with clinical and radiological signs of bowel ischemia.
  • Timely treatment can prevent significant mortality associated with these conditions.
Keywords:
Pneumatosis intestinalisPortomesentericVenous gas

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