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Indian Journal of Surgery
Medknow Publications on behalf of Association of Surgeons of India
ISSN: 0972-2068
Vol. 69, No. 2, 2007, pp. 74-76
Bioline Code: is07025
Full paper language: English
Document type: Research Article
Document available free of charge

Indian Journal of Surgery, Vol. 69, No. 2, 2007, pp. 74-76

 en Case Report - Portal venous gas during chemotherapy
Hirano, Yasumitsu; Nozawa ,Hiroshi; Hara, Takuo; Nakada, Kouichi; Oyama, Kaeko; Hada, Masahiro; Takagi, Takeshi & Hirano, Makoto

Abstract

A 56-year-old woman was admitted to our hospital with abdominal pain, nausea and diarrhea. She had previously operated for the ceacal cancer and performed chemotherapy with 5-fluorouracil (5-FU) and leucovorin (LV) after operation. She restarted chemotherapy with 5-FU and LV three weeks before, because size-up paraaortic lymphnode, lung metastasis and ovarian metastases were noted by follow-up CT scan. On physical examination at admission, mild tenderness located in the upper umbilicus was found. Blood examination showed leucocytopenia and neutropenia and C reactive protein level was slightly elevated. Under a diagnosis of enteritis as an adverse event of chemotherapy, conservative therapy including fasting and resuscitation was instituted. One day after admission, a high-grade fever was observed. A computed tomography (CT) of the abdomen showed portal venous gas (PVG). We did not suspect necrosis of the bowels and conservative therapy was continued. Follow-up CT imaging a day after revealed a disappearance of the PVG. It is believed that the radiographic detection of PVG is a life-threatening sign, but many of these cases do not require exploratory laparotomy. Contrast-enhanced CT should be performed to avoid unnecessary laparotomy.

Keywords
Chemotherapy, conservative therapy, portal venous gas

 
© Copyright 2007 Indian Journal of Surgery.

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