A Case of Hepatic Portal Venous Gas (HPVG) Occurring during Treatment with an <i>α</i>-Glucosidase Inhibitor (<i>α</i>-GI) for Type 2 Diabetes Mellitus that Rapidly Improved after Discontinuing the <i>α</i>-Glucosidase Inhibitor

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  • <i>α</i>-グルコシダーゼ阻害薬内服中に，門脈ガス血症を呈したが，中止後すみやかに消退した2型糖尿病の1例
  • 症例報告 α-グルコシダーゼ阻害薬内服中に門脈ガス血症を呈したが,中止後すみやかに消退した2型糖尿病の1例
  • ショウレイ ホウコク a-グルコシダーゼ ソガイヤク ナイフク チュウ ニ モンミャク ガス ケツショウ オ テイシタ ガ,チュウシ ゴ スミヤカニ ショウタイシタ 2ガタ トウニョウビョウ ノ 1レイ

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Abstract

A 78-year-old male patient was admitted with acute abdominal pain. He had developed type 2 diabetes mellitus in 1992 and was being treated with metformin. Since his HbA1c level had increased in October 2009, an α-GI, voglibose, was prescribed. One year later, he complained of abdominal symptoms, including abdominal distension, flatus, loose stools and constipation. These symptoms worsened in January 2011. He was thereafter admitted to the emergency department due to severe abdominal pain in March 2011. Plain abdominal radiography performed four hours after the onset of the abdominal pain showed dilation of the colon with gas retention. Plain abdominal computed tomography revealed a massive amount of hepatic portal gas, an enlarged colon with gas retention and regional thickening of the small intestine. The patient was treated conservatively with starvation. Enhanced abdominal CT performed seven hours after the onset of abdominal pain showed a rapid decrease in HPVG achieved by discontinuing the α-GI. The complete disappearance of the HPVG was observed after 48 hours. HPVG should therefore be taken into consideration in the differential diagnosis of gastrointestinal disorders when symptoms similar to the side effects of α-GIs reappear during treatment with an α-GI and become dominant.<br>

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