Year 2023 / Volume 115 / Number 4
Letter
Evolution of two unusual radiological findings in a patient with mesenteric ischemia

217-218

DOI: 10.17235/reed.2023.9429/2022

Cristina María Gras Gómez, José Ruiz Pardo, Javier Martín Cano, Irene Teruel-Lillo, José López-Fernández, Beatriz Estébanez-Ferrero, Pedro Antonio Sánchez Fuentes, Ángel Reina-Duarte,

Abstract
Portal pneumatosis has been considered an ominous sign associated with intestinal ischemia, with a mortality rate of up to 90% as long as it is associated with sepsis. However, the prognosis of mesenteric ischemia depends on the etiology rather than the presence of portal pneumatosis. We present a patient with portal pneumatosis that disappeared 24 hours after the first surgery, but irreversible ischemic lesions were established in the terminal ileum. It should be noted that the excretion of the intravenous contrast is mainly through the kidneys, and it can be eliminated through alternative routes such as the bile duct or the mucosa of the small intestine (vicariant excretion), especially in patients with renal pathology.
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04/04/2023 21:08:06
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References
1. Morimoto Y, Yamakawa T, Tanaka Y, et al. Recurrent hepatic portal venous gas in a patient with hemodialysis–dependent chronic renal failure. J Hepatobiliary Pancreat Surg. 2001;8:274-8
2. Hashimoto A, Moritani I, Shimizu A, et al. Hepatobiliary and pancreatic: Hepatic portal venous gas. J Gastroenterol Hepatol. 2007;22:277.
3. Hernando Sanz A, Díaz-Tobarra M, González Álvarez G. Hepatic portal venous gas. Should it be considered as an ominous radiologic sign? Rev Esp Enferm Dig. 2020 Jan;112(1):75. doi: 10.17235/reed.2019.6419/2019. PMID: 31755283.
4. Giménez Francés C, Tamayo Rodríguez ME, Albarracín Marín-Blázquez A. Non-oclusive mesenteric ischemia as a complication of dialysis. Rev Esp Enferm Dig. 2021;113:731-2
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Citation tools
Gras Gómez C, Ruiz Pardo J, Martín Cano J, Teruel-Lillo I, López-Fernández J, Estébanez-Ferrero B, et all. Evolution of two unusual radiological findings in a patient with mesenteric ischemia. 9429/2022


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Publication history

Received: 15/12/2022

Accepted: 27/12/2022

Online First: 23/01/2023

Published: 03/04/2023

Article Online First time: 39 days

Article editing time: 109 days


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