Nakao A, Iwagaki H, Isozaki H, Kanagawa T, Matsubara N, Takakura N, Tanaka N
First Department of Surgery, Okayama University, Medical School, Japan.
Anticancer Res. 1999 Nov-Dec;19(6C):5641-4.
We report a successfully treated case accompanied by portal venous gas, which was associated with splenic abscess due to penetration of colon cancer. In June, 1998, a 67-year-old Japanese man was referred to our hospital because of a continuous fever over 40 degrees C and portal venous gas detected by computed tomography (CT). CT revealed low density areas in the spleen and wall thickening of the descending colon next to the spleen. Barium-enema examination demonstrated an extrinsic filling defect in the splenic flexure of the colon. Splenectomy, resection of the pancreatic tail and left hemicolectomy were performed Histopathological studies showed moderately differentiated adenocarcinoma, which made a fistula at the bottom of the ulceration to the spleen. The postoperative course was uneventful. The portal venous gas was likely to have resulted from a bacterial infection in the portal venous systems secondary to the splenic abscess.
我们报告了一例成功治疗的伴有门静脉积气的病例，该病例与结肠癌穿透导致的脾脓肿有关。1998年6月，一名67岁的日本男性因持续发热超过40摄氏度且计算机断层扫描（CT）检测到门静脉积气而被转诊至我院。CT显示脾脏有低密度区，脾脏旁降结肠壁增厚。钡剂灌肠检查显示结肠脾曲有外在性充盈缺损。进行了脾切除术、胰尾切除术和左半结肠切除术。组织病理学研究显示为中分化腺癌，在溃疡底部与脾脏形成了瘘管。术后病程顺利。门静脉积气可能是脾脓肿继发门静脉系统细菌感染所致。
