Anaphylactoid Reaction from IV Contrast Dye Causing Ischemic Colitis with Portal Venous Gas.

Area of Science:

• Radiology
• Gastroenterology
• Immunology

Background:

• Portal venous gas (PVG) is a radiographic sign associated with significant intra-abdominal pathology.
• Common causes include bowel ischemia, but PVG can also occur in less common scenarios.
• PVG generally carries a high mortality rate.

Purpose of the Study:

• To report the first documented case of PVG secondary to an anaphylactoid reaction to intravenous contrast dye.
• To investigate the potential link between anaphylactoid reactions and ischemic colitis.
• To highlight conservative management and favorable outcomes in such cases.

Main Methods:

• Case report of a middle-aged woman presenting with PVG.
• Review of clinical presentation, diagnostic imaging, and patient history.
• Analysis of the association between intravenous contrast administration and PVG development.

Main Results:

• The patient developed PVG following administration of intravenous contrast dye.
• PVG was attributed to anaphylactoid-induced ischemic colitis.
• Conservative management led to a good clinical outcome.

Conclusions:

• Anaphylactoid reactions to intravenous contrast dye can be a rare cause of PVG.
• PVG secondary to contrast-induced anaphylaxis may be managed conservatively with favorable outcomes.
• This case expands the differential diagnosis for PVG.