Higashi Takaaki, Hayashi Hiromitsu, Takeyama Hideaki, Arima Kota, Taki Katsunobu, Takamori Hiroshi, Baba Hideo
Department of Gastroenterological Surgery Graduate School of Medical Sciences Kumamoto University Kumamoto Japan.
Surgery Center Saiseikai Kumamoto Hospital Kumamoto Japan.
Acute Med Surg. 2015 Jun 30;3(1):16-20. doi: 10.1002/ams2.125. eCollection 2016 Jan.
Hepatic portal venous gas is an indication for emergency surgery and reportedly has a high mortality rate. However, these days, cases of hepatic portal venous gas associated with milder disease are increasing. In this report, we compared two groups to investigate whether there were any objective indicators for selecting conservative therapy.
From July 2007 to August 2011, 19 patients with hepatic portal venous gas were evaluated at our hospital. The condition was diagnosed by computed tomography imaging. Vital signs, laboratory test results, and physical examination findings were compared.
The A group included 12 patients who could be treated with conservative therapy. The B group included 7 patients who could not be treated with conservative therapy. The combined mortality rate was 31.5% (6/19 patients). There was a significant difference in the pulse rate and shock index. In the A group, none of the patients had signs of peritoneal irritation. However, in the B group, physical examination revealed signs of peritoneal irritation in all patients.
Conservative therapy may be possible in patients with hepatic portal venous gas, depending on the cause. Evaluation of vital signs and serial changes on physical examination are important.
肝门静脉积气是急诊手术的指征，据报道其死亡率很高。然而，近年来，与病情较轻相关的肝门静脉积气病例正在增加。在本报告中，我们比较了两组患者，以调查是否存在选择保守治疗的客观指标。
2007年7月至2011年8月，我院对19例肝门静脉积气患者进行了评估。通过计算机断层扫描成像诊断病情。比较了生命体征、实验室检查结果和体格检查结果。
A组包括12例可接受保守治疗的患者。B组包括7例无法接受保守治疗的患者。总死亡率为31.5%（19例患者中的6例）。脉搏率和休克指数存在显著差异。A组患者均无腹膜刺激征。然而，B组患者体格检查显示所有患者均有腹膜刺激征。
根据病因，肝门静脉积气患者可能可行保守治疗。评估生命体征和体格检查的连续变化很重要。
