Tsang HY, Yong CC, Wang HP. Mesenteric ischemia with intrasplenic gas: A case report. World J Clin Cases 2025; 13(7): 101901 [DOI: 10.12998/wjcc.v13.i7.101901]
Corresponding Author of This Article
Hao-Ping Wang, MD, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, No. 123 Dapi Road, Niaosong District, Kaohsiung 833401, Taiwan. ss90272@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 6, 2025; 13(7): 101901 Published online Mar 6, 2025. doi: 10.12998/wjcc.v13.i7.101901
Mesenteric ischemia with intrasplenic gas: A case report
Hsiang-Yu Tsang, Chee-Chien Yong, Hao-Ping Wang
Hsiang-Yu Tsang, Chee-Chien Yong, Hao-Ping Wang, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833401, Taiwan
Author contributions: Tsang HY and Wang HP contributed to manuscript writing, editing, and data collection; Yong CC and Wang HP contributed to conceptualization and supervision; and all authors have read and approved the final manuscript.
Informed consent statement: As the patient had passed away, informed written consent for the publication of this report and any accompanying images was obtained from the patient’s daughter.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao-Ping Wang, MD, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, No. 123 Dapi Road, Niaosong District, Kaohsiung 833401, Taiwan. ss90272@gmail.com
Received: September 30, 2024 Revised: October 28, 2024 Accepted: November 13, 2024 Published online: March 6, 2025 Processing time: 56 Days and 2.2 Hours
Abstract
BACKGROUND
Acute mesenteric ischemia is a life-threatening disease. Intrasplenic gas is an extremely rare finding in such cases.
CASE SUMMARY
We report a case of a 79-year-old woman with a history of end-stage renal disease on hemodialysis for approximately 20 years, type 2 diabetes mellitus, and atrial fibrillation who presented with two days of epigastric pain. A computed tomography scan of the abdomen revealed intraperitoneal free air and significant intrasplenic gas. Laparoscopy revealed diffuse intestinal gangrene, and acute superior mesenteric ischemia was diagnosed. The patient died within 24 hours owing to profound shock.
CONCLUSION
Intrasplenic gas is an extremely rare finding on computed tomography imaging in cases of acute mesenteric ischemia.
Core Tip: Acute mesenteric ischemia is a life-threatening condition with a high mortality rate. Early diagnosis and timely surgical intervention are critical for improving patient outcomes. Pneumatosis intestinalis and hepatic portal venous gas are typical imaging findings. Intrasplenic gas, although rare, indicates a critical situation that clinicians must recognize. We presented this case with intrasplenic gas being detected in the computed tomography, while acute mesenteric ischemia was diagnosed in the beginning, to remind all the clinicians about this rare image finding.
