- 期刊
Hepatic Portal Venous Gas Associated With Acute Mesenteric Infarction-A Case Report
肝內門靜脈積氣併發於急性腸繫膜梗塞一病例報告
摘要
肝內門靜脈積氣被認為是一種預候不良的徵象，經常表示病患需要緊急外科手術治療，許多腹部疾病及醫源性情況能併發肝內門靜脈積氣，常見者包括腸壞死、腹腔內膿瘍、腸阻塞與經大陽鋇劑或內視鏡檢查後之潰瘍性大腸炎，而其中死亡率最高者當屬腸梗塞。肝內門靜脈積氣不易由傳統的腹部 X 光素片檢出，對於偵測肝內門靜脈積氣及其成因，超音波與電腦斷層掃瞄是較具價值的方法。吾人報告一例急性腸繫膜梗塞患者，具併發肝內門靜脈積氣，經由超音波檢查早期偵測得知。其後之電腦斷層掃描不僅呈現肝內門靜脈積氣之特殊影像，並發現有小腸腸壁內積氣與氣體存於上腸繫膜靜脈中，而後面兩項發現為腸繫膜梗塞之診斷線索。此患者經緊急手術後存活。
關鍵字
無資料並列摘要
Hepatic portal venous gas (HPVG) is considered as an ominous prognostic sign and indicates the need for urgent surgical Intervention. It has been associated with a wide variety of abdominal catastrophes, but the commonest and most serious one is infarcted bowel. This disease entity is difficult to be detected by conventional radiography. Ultrasonography and computed tomography have been reported to be more valuable methods in detecting HPVG and Its cause. We report a case of HPVG associated with acute mesenteric infarction, which was detected early by ultrasonography. The computed tomography done later not only showed typical features of HPVG, but also disclosed Intramural gas in the small Intestine and gas In the superior mesenteric veins, which were diagnostic clues for acute mesenteric infarction. The patient survived after urgent surgery.
延伸閱讀
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