McElvanna Kevin, Campbell Alastair, Diamond Tom
Department of Hepatobiliary Surgery, Mater Infirmorum Hospital, 47-51 Crumlin Road BT14 6AB.
Ulster Med J. 2012 May;81(2):74-8.
Hepatic portal venous gas is a rare imaging finding most commonly associated with intestinal ischaemia and high mortality. Increased use of advanced imaging techniques has resulted in increased reporting and recognition of hepatic portal venous gas. Advanced imaging can also recognise the many associated pathologies which have variable management strategies and prognoses.
We report 3 non-fatal cases and review the pathogenesis, aetiology, diagnosis, management and prognosis of hepatic portal venous gas.
Once considered an indication for urgent surgery, hepatic portal venous gas is a rare imaging finding. More recently, HPVG has been recognised to be associated with various benign causes many of which may be treated non-operatively. However, intestinal ischaemia remains the most common cause and the most important to exclude. CT is the diagnostic modality of choice. The underlying cause determines the treatment strategy and outcome.
肝门静脉积气是一种罕见的影像学表现，最常与肠缺血相关，死亡率高。先进成像技术使用的增加导致肝门静脉积气的报告和识别增多。先进成像还能识别许多相关病变，这些病变有不同的管理策略和预后。
我们报告3例非致命病例，并回顾肝门静脉积气的发病机制、病因、诊断、管理和预后。
肝门静脉积气曾被视为紧急手术的指征，是一种罕见的影像学表现。最近，人们认识到肝门静脉积气与多种良性病因有关，其中许多病因可采用非手术治疗。然而，肠缺血仍然是最常见的病因，也是最重要的需要排除的病因。CT是首选的诊断方式。潜在病因决定治疗策略和结果。
