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A case of hepatic portal venous gas caused by chemo-radiation therapy for an advanced esophageal cancer
Authors:Takeshi Matsutani  Koji Sasajima  Hiroshi Maruyama  Masayuki Miyamoto  Tadashi Yokoyama  Seiji Suzuki  Ken Yanagi  Moto Kashiwabara  Akihisa Matsuda  Takashi Tajiri
Institution:Department of Surgery, Nippon Medical School Tama-Nagayama Hospital.
Abstract:Hepatic portal venous gas(HPVG)is a rare condition with a poor prognosis. A 40-year-old man underwent esophagectomy for stage IV esophageal cancer followed by chemotherapy. Four months later, he admitted to our hospital because of the increases of residual tumors and started chemoradiotherapy(CRT)with 5-FU, CDDP and radiation. Computed tomography(CT)scan revealed PR, and blood examination showed decreases in WBC and platelet counts. Fourty days after CRT, he suddenly complained severe pain in the left chest and abdomen, and vomiting. CT scan showed HPVG in the left lobe of the liver and pneumatosis cystoides intestinalis in the wall of the gastric tube. He died of multiple organ failure. To our knowledge, this is a first case of HPVG associated with CRT for esophageal cancer.
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