Publication: Ischemic Portal Venous Gas and Pneumatosis Intestinalis Managed Conservatively in a Patient with Rheumatic Heart Disease and Warfarin Induced Coagulopathy: A Case Report
| creativeworkseries.issn | JNMA Print ISSN: 0028-2715; Online ISSN: 1815-672X | |
| dc.contributor.author | Dahal, Prajwal | |
| dc.contributor.author | Paudel, Sharma | |
| dc.contributor.author | Sah, Rakesh Kumar | |
| dc.contributor.author | Parajuli, Sabina | |
| dc.contributor.author | Kayastha, Kiran | |
| dc.date.accessioned | 2025-08-25T06:40:12Z | |
| dc.date.available | 2025-08-25T06:40:12Z | |
| dc.date.issued | 2023 | |
| dc.description | Prajwal Dahal Department of Radiology and Imaging, Grande International Hospital, Tokha, Kathmandu, Nepal Sharma Paudel Department of Radiology and Imaging, Tribhuvan University Teaching Hospital, Maharajguj, Kathmandu, Nepal Rakesh Kumar Sah Department of General Surgery, Grande International Hospital, Tokha, Kathmandu, Nepal Sabina Parajuli Department of Pathology, Nepal Academy of Health Sciences, Bir Hospital, Mahaboudha, Kathmandu, Nepal Kiran Kayastha Grande International Hospital, Tokha, Kathmandu, Nepal | |
| dc.description.abstract | Abstract Mesenteric ischemia is a surgical emergency. The presence of hepatic portal venous gas and pneumatosis intestinalis is a frequent finding in computed tomography. Not all hepatic portal venous gas and pneumatosis intestinalis are due to mesenteric ischemia. A 70-year-old female, with a known case of diabetes mellitus, rheumatic heart disease and atrial fibrillation under warfarin presented with diffuse abdominal pain, multiple episodes of vomiting and ecchymosis in bilateral flanks. Evaluation of the coagulation profile suggested warfarin-induced coagulopathy. Portal venous gas was detected during an ultrasound examination. Subsequent contrast-enhanced computed tomography abdomen showed hepatic portal venous gas, pneumatosis intestinalis, paucity of branches of the ileocolic artery, and reduced enhancement of caecum and ascending colon. Mild ascites were present in the pelvis. Arterial blood gas analysis revealed compensated metabolic acidosis. The patient was managed conservatively and discharged after nine days of hospital admission. Conservative approach can be considered for suspected mesenteric ischemia in surgically unfit candidates. | |
| dc.identifier | https://doi.org/10.31729/jnma.8302 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.14572/2008 | |
| dc.language.iso | en_US | |
| dc.publisher | Nepal Medical Association | |
| dc.title | Ischemic Portal Venous Gas and Pneumatosis Intestinalis Managed Conservatively in a Patient with Rheumatic Heart Disease and Warfarin Induced Coagulopathy: A Case Report | |
| dc.type | Other | |
| dspace.entity.type | Publication | |
| local.article.type | Case Report | |
| oaire.citation.endPage | 836 | |
| oaire.citation.startPage | 834 | |
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| relation.isJournalIssueOfPublication.latestForDiscovery | 22c9f6ca-26ae-4e5a-8542-94012a3e664c | |
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