A CASE OF PERFORATION OF GASTRIC ULCER WITH PORTAL VENOUS GAS

A 44-year-old man was admitted to the hospital because of epigastralgic pain. During abdominal CT scanning, he was brought into cardiac arrest on a sudden. After he had revived, an emergency laparotomy was performed with a diagnosis of gastrointestinal perforation with portal venous gas (PVG). At laparotomy, perforation of gastric ulcer with hematoma at the angular notch of the stomach and existence of ischemia with necrosis at ileo-cecal region were revealed. Gastrostomy and peritoneal drainage were carried out. PVG is relatively rare, and is caused by gastrointestinal necrosis in most cases. It is unknown that PVG in our case was caused by the perforation of gatric ulcer, shock and DIC due to peritonitis, or necrotic enteritis. We report here the case because of its rare clinical course.