Abstract
We report here the case of an 81-year old male referred to our hospital with abrupt onset severe abdominal pain. Physical examination showed severe abdominal tenderness with mild rebound tenderness and rectal tumor was palpable on digital examination. Abdominal computed tomography revealed ascites with a thickened small intestinal wall and gas in the hepatic portal venous system. Superior mesenteric arteriography revealed irregular strictures without arterial occlusion. A diagnosis of ischemic enteritis was determined, and an emergency laparotomy was performed. Resection of a 100cm long segment of necrotic ileum, and a looped colostomy of the sigmoid colon were perfomed. The patient was discharged on the 61th postoperative day after receiving radiation therapy for rectal cancer. We made the diagnosis of non-occlusive mesenteric ischemia from the findings of arteriography. No evidence of arterial diseases was found in the resected specimens. Indications for operation should be carefully decided because portal venous gas accompanys ischemic bowel, as well as other diseases.
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