Stenotic Ischemic Enteritis with Concomitant Hepatic Portal Venous Gas and Pneumatosis Cystoides Intestinalis

Intern Med. 2018 Jul 15;57(14):1995-1999. doi: 10.2169/internalmedicine.0367-17. Epub 2018 Feb 28.

Abstract

A 69-year-old man was admitted to a hospital with complaints of abdominal pain. Computed tomography showed hepatic portal venous gas and pneumatosis cystoides intestinalis. Conservative treatment was effective; however, after discharge, he developed complaints of vomiting. Fluoroscopic enteroclysis revealed a stricture in the jejunum necessitating admission to our hospital. Transoral balloon-assisted enteroscopy showed a circumferential ulcer with a stricture. The stricture was surgically resected, and a histopathological examination was consistent with ischemic enteritis. Stenotic ischemic enteritis should be considered among the differential diagnoses in a patient presenting with hepatic portal venous gas and pneumatosis cystoides intestinalis showing small intestinal obstruction.

Keywords: balloon-assisted enteroscopy; hepatic portal venous gas; intestinal stricture; ischemic enteritis; pneumatosis cystoides intestinalis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Enteritis / diagnostic imaging
  • Enteritis / physiopathology*
  • Enteritis / surgery*
  • Humans
  • Jejunal Diseases / diagnostic imaging
  • Jejunal Diseases / physiopathology
  • Jejunum / diagnostic imaging*
  • Male
  • Mesenteric Ischemia / diagnostic imaging
  • Mesenteric Ischemia / physiopathology*
  • Mesenteric Ischemia / surgery*
  • Pneumatosis Cystoides Intestinalis / diagnostic imaging
  • Pneumatosis Cystoides Intestinalis / physiopathology*
  • Pneumatosis Cystoides Intestinalis / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome