Iwamuro Masaya, Okamoto Yuki, Kanzaki Hiromitsu, Kawano Seiji, Tanabe Shunsuke, Yamamoto Hiromasa, Kawahara Yoshiro, Okada Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences.
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Nihon Shokakibyo Gakkai Zasshi. 2018;115(7):655-661. doi: 10.11405/nisshoshi.115.655.
A 69-year-old Japanese man underwent successful percutaneous endoscopic gastrostomy (PEG) without any intra-procedural adverse event. However, 3 days postoperatively, he presented with melena and bloody discharge from the gastrostomy tube. Computed tomography revealed gastric emphysema, hepatic portal venous gas, portal vein thrombosis, and swelling of the ascending colon. We administered antibiotics and discontinued enteral feeding; this resulted in resolution of gastric emphysema, hepatic portal venous gas, and portal vein thrombosis and an improvement in the swelling of the ascending colon. To the best of our knowledge, till date, only three patients have been reported to develop gastric emphysema and hepatic portal venous gas after PEG. All previously reported patients were treated with antibiotics and/or discontinuation of enteral feeding, exhibiting recovery within 6-14 days. Although the occurrence of gastric emphysema and hepatic portal venous gas after a PEG procedure is rare, conservative management can ensure recovery in such patients.
一名69岁的日本男性成功接受了经皮内镜下胃造口术（PEG），术中未出现任何不良事件。然而，术后3天，他出现了黑便和胃造口管血性分泌物。计算机断层扫描显示胃积气、肝门静脉积气、门静脉血栓形成以及升结肠肿胀。我们给予了抗生素并停止肠内喂养；这导致胃积气、肝门静脉积气和门静脉血栓形成得到缓解，升结肠肿胀也有所改善。据我们所知，迄今为止，仅有3例患者在PEG术后出现胃积气和肝门静脉积气的报道。所有先前报道的患者均接受了抗生素治疗和/或停止肠内喂养，在6 - 14天内康复。虽然PEG术后发生胃积气和肝门静脉积气的情况罕见，但保守治疗可确保此类患者康复。
