AN ELDERLY CASE OF CROHN'S DISEASE PRESENTING AS HEPATIC PORTAL VENOUS GAS

DOI
  • JOMEN Wataru
    Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital. Dept. of Medical Oncology and Hematology, Internal Medicine, Sapporo Medical University.
  • KURODA Hiroyuki
    Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
  • FUJII Shigeyuki
    Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
  • MAEDA Masahiro
    Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
  • SATO Masanori
    Dept. of Medical Oncology and Hematology, Internal Medicine, Sapporo Medical University.
  • KATO Junji
    Dept. of Medical Oncology and Hematology, Internal Medicine, Sapporo Medical University.
  • FUJITA Miri
    Dept. of Pathology and Clinical Laboratoly, Steel Memorial Muroran Hospital.

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Other Title
  • 門脈ガス血症を契機に診断した高齢発症Crohn病の1例

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Abstract

A 72-year-old man was admitted to our hospital with the complaint of abdominal pain. CT showed inflammation in the ileocecum and hepatic portal venous gas ; neither intestinal necrosis nor perforation was observed. Therefore, he was admitted to our hospital for conservative treatment. Since his clinical course was satisfactory after admission, he was discharged. However, he returned to visit our hospital one week later with the main complaint of abdominal pain. Since CT showed a small intestinal obstruction starting from the ileocecum, he was readmitted to our hospital. After insertion of an ileus tube to reduce intestinal pressure, he underwent colonoscopy which revealed a longitudinal ulcer and obstruction at the terminal ileum. Upon examination of biopsy samples obtained from the ulcer, he was diagnosed as having Crohn's disease. There have been few reports on elderly-onset Crohn's disease, and hepatic portal venous gas in patients with Crohn's disease is rare.

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