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Transient portal venous gas secondary to acute gastric dilatation.

Accepted version
Peer-reviewed

Type

Article

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Authors

Koh, Shern Wai 
Bath, Michael F 
Nair, Manoj 

Abstract

A female patient in her 60s with a history of Parkinson's disease developed epigastric and retrosternal chest pain, with associated vomiting. On examination, she had a distended abdomen with no focal peritonism. A computed tomography (CT) pulmonary angiogram was organized, which demonstrated no evidence of pulmonary emboli, but an incidental finding of gas within the liver peripheries and gastric fundal wall. A plain film abdominal radiograph demonstrated a significantly distended stomach. Thus, acute gastric dilatation was diagnosed. A nasogastric tube was introduced and intravenous fluids were given promptly. An urgent CT scan of abdomen and pelvis with intravenous contrast demonstrated interval reduction with only minor residual gas evident within the left lobe of the liver and gastric fundal wall. We report the case of transient portal venous gas, secondary to acute gastric dilatation, most likely caused by a combination of opioid analgesia and gastric dysmotility from Parkinson's disease.

Description

Keywords

gastroenterology, general surgery, ischaemia, radiology

Journal Title

J Surg Case Rep

Conference Name

Journal ISSN

2042-8812
2042-8812

Volume Title

Publisher

Oxford University Press