Rajković Z, Papeš D, Altarac S, Arslani N
Zabok General Hospital, Croatia.
Ann R Coll Surg Engl. 2012 Mar;94(2):e95. doi: 10.1308/003588412X13171221589171.
We present two patients with air found in the right upper quadrant on standard abdominal x-ray. One was diagnosed with pneumobilia and underwent elective surgery for a bilioenteric fistula. The other was diagnosed with portal vein gas and underwent an emergency exploratory laparotomy at which a superior mesenteric artery embolism was found. The differential diagnostic criteria for pneumobilia and portal vein gas are described. If portal venous gas is found on x-ray in patients with abdominal pain, it is recommended that management is aggressive, meaning an emergency exploratory laparotomy, because mortality in such cases is approximately 75%.
我们报告两名患者，其在标准腹部X线片上显示右上腹有气体。其中一名被诊断为气胆症，并因胆肠瘘接受了择期手术。另一名被诊断为门静脉积气，并接受了急诊剖腹探查术，术中发现肠系膜上动脉栓塞。文中描述了气胆症和门静脉积气的鉴别诊断标准。如果在腹痛患者的X线片上发现门静脉积气，建议积极处理，即进行急诊剖腹探查术，因为此类病例的死亡率约为75%。
