A 43-year-old man was admitted in our hospital because of severe Pneumocystis jerovecii pneumonia [formerly called Pneumocystis Carinii Pneumonia (PCP)]. During his stay in Intensive care unit, he developed vomiting, abdominal distension and absent bowel sounds. On abdominal radiograph, hepatic portal venous gas (HPVG) and pneumatosis intestinalis of the small and large intestine were present. HPVG caused by necrotizing enterocolitis was diagnosed, and an emergency laparotomy was thus performed that showed necrosis of the small and large bowel. Bowel resection was done. The patient is alive as of two years after operation. The prognosis of necrotizing enterocolitis accompanied by HPVG and pneumatosis intestinalis is extremely poor. The presence of HPVG suggests the occurrence of a serious lesion in the abdominal cavity. Therefore, appropriate treatment should be performed immediately.
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