A case of a gas embolism in the aorta induced by necrotizing gastroenteritis.
A 69-year-old man with epigastralgia and vomiting continuing for 7 hours was transported to this department. At the time of examination, he was drowsy and in a state of shock. He showed a markedly distended abdomen and epigastric tenderness. Arterial blood gas showed hypoxia and severe metabolic acidosis. Computed tomography revealed intramural gas in the wall of the stomach and small intestine, and multiple gas in the portal vein, mesenteric vein, pulmonary artery, coronary artery, and ascending aorta. A laboratory and radiographic examination indicated dehydration, inflammation, liver dysfunction, renal failure, necrotizing gastroenteritis, and multiple air embolisms. He died soon after these examinations. The autopsy results supported the clinical diagnosis and did not show any aortitis or an obvious right-left shunt. Physicians should note the presence of an arterial gas embolism in patients with pneumatosis intestinalis and massive gas in the venous system, which can be immediately fatal.
Yanagawa
Youichi
Y
Department of Traumatology and Critical Care Medicine, National Defense Medical College. yanagawa@ndmc.ac.jp
Iwamoto
Shinichirou
S
Hagiwara
Akiyoshi
A
Seno
Souichirou
S
D000368:Aged; D001011:Aorta; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology*; D017809:Fatal Outcome; D005759:Gastroenteritis / Q000150:complications*; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D008297:Male; D009336:Necrosis; D011859:Radiography