Successful Conservative Treatment for Portal Venous Gas Following Pancreaticoduodenectomy

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  • 膵頭十二指腸切除術後に門脈ガス血症をきたし保存的加療にて軽快した1例

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A 71-year-old man who had undergone percutaneous transhepatic biliary drainage (PTBD) for obstructive jaundice in another hospital was admitted to our hospital for further evaluation and treatment. He was diagnosed as having distal bile duct cancer, and underwent a pancreaticoduodenectomy. On the 11th postoperative day, he developed fever and vomiting, without signs of peritoneal irritation or acidosis. Abdominal ultrasound demonstrated high-intensity echoes moving in the portal vein. CT showed branching radiolucencies in the peripheral intrahepatic portal vein branches, gastric dilatation, and gastric emphysema. Portal venous gas due to increased intragastric pressure was diagnosed. Since his condition was stable, he was conservatively treated with gastric decompression and antibiotic therapy. Portal venous gas disappeared the next day, and he resumed oral nutrition one week later. His subsequent clinical course was uneventful. We report herein on a patient who developed portal venous gas after pancreaticoduodenectomy, and was successfully treated conservatively.

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