18 April 2024
: Case report 
Potential Indicators of Intestinal Necrosis in Portal Venous Gas: A Case Report of an 82-Year-Old Woman on Long-Term Hemodialysis with Ascites and Pneumatosis Coli
Management of emergency care
Yoshio Hisata12AEF, Naoko E. Katsuki1AEF, Masaki Tago1AEG*, Tomoyo Nishi1E, Tomotaro Nakashima1E, Yoshimasa Oda13E, Shu-ichi Yamashita1EDOI: 10.12659/AJCR.942966
Am J Case Rep 2024; 25:e942966
Table 1. Physical and image findings in 3 episodes.
| Episode 1 | Episode 2 | Episode 3 | |
|---|---|---|---|
| Outcome | Survival | Survival | Deceased |
| Score of Koami criteria | 1 | 0 | 2 |
| Vital signs on admission | |||
| Glasgow Coma Scale | 15 | 15 | 14 |
| Body temperature | 36.3°C | 35.6°C | 35.9°C |
| Blood pressure (mmHg) | 125/53 | 115/56 | 107/52 |
| Pulse rate per min | 60, regular | 70, regular | 69, regular |
| Respiratory rate per min | 18 | 16 | 29 |
| Bloating | No | No | Yes |
| Abdominal pain | Yes | Yes | Yes |
| Continuity of abdominal pain | Yes | No | Yes |
| Approximate duration of abdominal pain (h) | 1.75 | 1.75 | 4.5 |
| Peritoneal sign | No | No | No |
| Pneumatosis intestinalis | Yes | No | Yes |
| Appearance of pneumatosis intestinalis | Bubbly | None | Linear |
| Distribution of portal venous gas | Left lobe, right anterior segment | Left lobe, right anterior segment | Both lobes involving right posterior |
| Ascites | Yes | Yes | Yes |
| Volume of ascites | Moderate | Moderate | Large |
| Intestinal distension | No | No | Yes |
| Poor intestinal wall enhancement | Yes | No | Yes |
| * The score is calculated by adding 1 point each for systolic blood pressure 387 IU/L, and pneumatosis intestinalis on computed tomography scan. Prediction of intestinal necrosis had a sensitivity of 100% and specificity of 78.9%, with 0–1 points as negative and 2–3 points as positive (reference ). | |||