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Chirurgia 2007 October;20(5):261-2

language: English

Pneumatosis cystoides intestinalis and hepatic portal venous gas: findings of severe bowel ischemia

Manzelli A., Rossi P., Sica G. S., Di Lorenzo N., Cerno L., Gaspari A. L.

General Surgery Division Department of Surgery Tor Vergata University Hospital Tor Vergata University, Rome, Italy


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There is usually a grave and poor prognosis when pneumatosis cystoides intestinalis and hepatic portal venous gas are associated with ischemic bowel disease. We describe a case of a 75-year-old woman admitted to our emergency department presenting abdominal distension and complaining severe abdominal pain and vomiting. A CT-Angio reveled pneumatosis cystoides intestinalis and hepatic portal venous gas. An emergency laparotomy was performed and a large intestinal necrosis was diagnosed. The surgical procedure consisted in extended resection of large part of small bowel resulting in a short-bowel condition. Pneumatosis cystoides intestinalis and hepatic portal venous gas suggests the presence of severe bowel ischemia associated with a very poor prognosis. An appropriate treatment should be performed immediately.

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