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A Case of Pneumatosis Cystoides Intestinalis and Portal Venous Gas Accompanied by Emphysematous Pyelonephritis in Type 2 Diabetes Mellitus

Journal of Korean Diabetes 2014³â 15±Ç 1È£ p.45 ~ p.50

À¯½ÂÈñ(Yu Seung-Hee) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
¾ö¿µ½Ç(Eom Young-Sil) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
À̵¿¹Î(Lee Dong-Min) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
À̽ÃÈÆ(Lee Si-Hoon) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
±è¿¬¼±(Kim Yeun-Sun) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
À̱⿵(Lee Ki-Young) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
±èº´ÁØ(Kim Byung-Joon) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
±è±¤¿ø(Kim Kwang-Won) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú
¹ÚÀ̺´(Park Ie-Byung) - °¡Ãµ´ëÇб³ Àǰú´ëÇÐ ³»°ú

Abstract

Diabetes mellitus is a major risk factor for urinary tract infection (UTI); emphysematous pyelonephritis (EP), a complication of UTIs, often occurs in patients with underlying, poorly controlled diabetes mellitus. We report the case of an 87-year-old woman with EP in type 2 diabetes mellitus who developed pneumatosis cystoides intestinal is (PCI) with portal venous gas. PCI is a radiographic finding, which is found in a linear or cystic form of gas in the submucosa or subserosa of the bowel wall. PCI has two common presentations. Primary PCI is a benign idiopathic condition. Secondary PCI is associated with a wide variety of gastrointestinal and no ngastrointestinal diseases. PCI with portal venous gas in particular is associated with ischemic gastrointestinal disease. Initial pre-enhanced abdominopelvic computed tomography showed EP in the right kidney without PCI. Newly occurring PCI and hepatic portal venous gas were found in the right ascending colon after EP improved. This is a rare case of PCI accompanied by emphysematous pyelonephritis in type 2 diabetes mellitus. The patient`s general condition improved with intravenous antibiotics and fluid therapy without a surgical approach. However, she was discharged without further treatment because the family refused any further evaluations and treatments.

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Pneumatosis cystoides intestinalis, Pyelonephritis, Diabetes mellitus
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