부산대학교 도서관

In this case a 73-year-old female suffered from diffuse abdominal pain was taken to a local hospital. Emergent abdominal CT was performed and demonstrated extensive hepatic portal venous gas, mesenteric venous gas, wall thickening of the small intestinal loops and ascites. Then, she was immediately transferred to our ER under the impression of ischemic bowel disease. At the time of her admission to our ER, diffuse abdominal tenderness still persisted and a second abdominal CT was arranged which was performed about 5h after the first CT scan. The repeated CT scan revealed near complete resolution of the portomesenteric venous gas. Tracing back her medical history, she was a case of coronary artery disease who received coronary artery bypass graft surgery about seven years ago and coronary artery stent 5 days ago. She was discharged 40 days later with conservative treatment. This case underscores the role of conservative management. To understand the etiology, pathology and physiology of portomesenteric venous gas, to distinguish between iatrogenic and non-iatrogenic cases, to provide timely treatment and the most appropriate treatment.