title: Improvements in Pneumatosis Cystoides Intestinalis and Hepatic Portal Venous Gas with Conservative Therapy in a Patient on Maintenance Dialysis.
abstract: A 77-year-old man on maintenance dialysis developed hypotension, nausea and abdominal pain one hour after beginning to undergo hemodialysis. Abdominal computed tomography (CT) showed gas shadows in the intrahepatic portal vein and the small intestinal wall, but no signs indicating intestinal necrosis. Three days later, the gas shadows on abdominal CT disappeared by conservative therapy. In cases with both pneumatosis cystoides intestinalis and hepatic portal venous gas, intestinal necrosis should therefore be suspected and surgical therapy should also be considered, particularly in hemodialysis patients with a risk of intestinal ischemia. However, conservative therapy may be an option in cases with no intestinal necrosis.
authors.affiliation: Department of Internal Medicine, Japan Community Health Care Organization, Isahaya General Hospital, Japan.
authors.forename: Kenta
authors.initials: K
authors.lastname: Torigoe
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Arai
authors.forename: Ayuko
authors.initials: A
authors.lastname: Yamashita
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Muraya
authors.forename: Yoko
authors.initials: Y
authors.lastname: Obata
authors.forename: Tomoya
authors.initials: T
authors.lastname: Nishino
mesh_terms: D000368:Aged; D000072700:Conservative Treatment / Q000379:methods*; D006801:Humans; D008297:Male; D011006:Pneumatosis Cystoides Intestinalis / Q000175:diagnosis / Q000628:therapy*; D011169:Portal Vein / Q000473:pathology; D006435:Renal Dialysis; D014057:Tomography, X-Ray Computed