Portomesenteric Venous Gas Secondary to Acute Diverticulitis Colovenous Fistula

Oral and intravenous contrast-enhanced abdominal and pelvic CT scan showed several foci of air in the inferior mesenteric veins (IMV) and intrahepatic portal venous system with thrombus in the right posterior branch of the portal vein (Fig. 1). The CT scan also showed focal thickening of the sigmoid...

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Published inThe American surgeon Vol. 84; no. 4; pp. 123 - 124
Main Authors Yates, Tari-Ann Erica, Pasipanodya, Alphonse, Sathyanarayana, Sandeep Anantha
Format Journal Article
LanguageEnglish
Published Los Angeles, CA SAGE Publications 01.04.2018
SAGE PUBLICATIONS, INC
Subjects
Abdomen
Antibiotics
Blood
Colon
Computed tomography
Escherichia coli
Fistula
Fistulae
Ischemia
Medical imaging
Ostomy
Surgery
Thickening
Tennessee
Nashville Tennessee
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Summary:Oral and intravenous contrast-enhanced abdominal and pelvic CT scan showed several foci of air in the inferior mesenteric veins (IMV) and intrahepatic portal venous system with thrombus in the right posterior branch of the portal vein (Fig. 1). The CT scan also showed focal thickening of the sigmoid colon with inflammatory changes and no signs of pneumoperitoneum, free intraperitoneal fluid, peridiverticular abscess, or intestinal ischemia. The diagnosis is often delayed because clinical symptoms are not specific and is performed mainly by imaging studies.4 Our patient had an episode of acute diverticulitis with PMVG on presentation with a colovenous fistula (enteral contrast traversing from sigmoid colon into the IMV), requiring a sigmoid resection with end colostomy and had a successful recovery.
Bibliography:ObjectType-Case Study-3
SourceType-Scholarly Journals-1
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ISSN:0003-1348
1555-9823
DOI:10.1177/000313481808400403