Abstract
Portomesenteric vein gas can occur owing to a variety of interraleted factors such as loss of mucosal integrity and intraluminal overpressure, and the most common and serious cause is bowel ischemia, which requires urgent laparotomy. Nevertheless, when portal venous gas is caused by nonischemic causes, surgery is not required and it can be treated conservatively. So, its features should be carefully evaluated at CT scan, together with clinical findings. The authors report a case of an old male with portomesenteric venous system gas after CT colonography, without evidence of pneumatosis intestinalis or colonic perforation. A CT scan without enema was required after 24 hours in absence of worsened patient conditions, revealing the disappearance of gas in mesenteric vein and in the portal venous system.
Highlights
CT colonography is a minimally invasive examination which could be currently considered as a possible alternative to conventional colonoscopy as a screening test for colorectal cancer [1].This procedure requires an adequate colonic distension, which is achieved via a small flexible rectal catheter by either manual insufflation of room air or automated carbon dioxide delivery.The reported symptomatic complication rates at optical colonoscopy are higher than those for virtual colonoscopy
Portomesenteric vein gas can occur owing to a variety of interraleted factors such as loss of mucosal integrity and intraluminal overpressure, and the most common and serious cause is bowel ischemia, which requires urgent laparotomy
The authors report a case of an old male with portomesenteric venous system gas after CT colonography, without evidence of pneumatosis intestinalis or colonic perforation
Summary
CT colonography (virtual colonoscopy, CTC) is a minimally invasive examination which could be currently considered as a possible alternative to conventional colonoscopy as a screening test for colorectal cancer [1]. This procedure requires an adequate colonic distension, which is achieved via a small flexible rectal catheter by either manual insufflation of room air or automated carbon dioxide delivery. The reported symptomatic complication rates at optical colonoscopy are higher than those for virtual colonoscopy. The most common complication of optical colonoscopy is bowel perforation, which is reported as at an approximate rate of 0.06%–0,019% or one of 200–1300 patients in studies with large series of patients [2]. We are showing a case report of portomesenteric venous system gas as a benign complication of CTC following room air colonic distension
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