Saudi Journal of Gastroenterology
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LETTER TO EDITOR  
Year : 2018  |  Volume : 24  |  Issue : 1  |  Page : 69
Severe pneumatosis intestinalis with portal venous gas


1 Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Niigata, Japan
2 Department of Integrated Medicine, Minami Uonuma Hospital, Niigata, Japan

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Date of Web Publication14-Feb-2018
 

How to cite this article:
Shindo M, Ito K, Tabei K, Morishita Y. Severe pneumatosis intestinalis with portal venous gas. Saudi J Gastroenterol 2018;24:69

How to cite this URL:
Shindo M, Ito K, Tabei K, Morishita Y. Severe pneumatosis intestinalis with portal venous gas. Saudi J Gastroenterol [serial online] 2018 [cited 2019 Dec 7];24:69. Available from: http://www.saudijgastro.com/text.asp?2018/24/1/69/225395




Sir,

An 81-year-old man who had habitual constipation visited our hospital complaining of vomiting. His abdomen showed distension without tenderness. Abdominal X-ray showed dilatation of stomach, with gas in the small and large intestines [Figure 1]. Computed tomography revealed numerous gas cysts in the wall of stomach, small and large intestines [Figure 2], arrows], and portal venous system [Figure 2]. He was diagnosed with severe pneumatosis intestinalis with portal venous gas. Despite intensive care including antibiotic agents and infusions, he died several hours after visiting the hospital. This is a rare case of pneumatosis intestinalis because not only part of the intestine was involved, as previously reported,[1] but also the whole intestine and the stomach. The pathogenesis of pneumatosis intestinalis is considered to be complex and multifactorial.[2] In this case, increased pressure on the intestinal lumen by habitual constipation may have contributed to the development of pneumatosis intestinalis.
Figure 1: Abdominal X-ray

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Figure 2: Abdominal computed tomography

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Wu LL, Yang YS, Dou Y, Liu QS. A systematic analysis of pneumatosis cystoides intestinalis. World J Gastroenterol 2013;19:4973-8.  Back to cited text no. 1
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2.
Pieterse AS, Leong AS, Rowland R. The mucosal changes and pathogenesis of pneumatosis cystoides intestinalis. Hum Pathol 1985;16:683.  Back to cited text no. 2
[PUBMED]    

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Correspondence Address:
Dr. Yoshiyuki Morishita
Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama – 330-8503
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjg.SJG_545_17

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    Figures

  [Figure 1], [Figure 2]



 

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