Hosokawa Takahiro, Yamada Yoshitake, Tanami Yutaka, Sato Yumiko, Hosokawa Mayumi, Oguma Eiji
Department of radiology, saitama children medical center, saitama, japan.
Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Med Ultrason. 2019 Feb 17;21(1):30-36. doi: 10.11152/mu-1727.
To evaluate ultrasound findings in order to determine potential predictors of prognosis in pediatric patients with portal venous gas (PVG) detected by ultrasound.
Thirty-nine children were included and divided into two groups: benign PVG (n=24) and life-threatening PVG (n=15; 6 surgical interventions and 9 deaths). Possible predictors, i.e., the location of PVG in the liver, the distribution of intestinal pneumatosis, ascites and free air were compared between the two groups.
A significant difference was noted between the two groups in terms of the distribution of intestinal pneumatosis (limited to the large bowel, benign vs life-threatening = 60.9% (14/23):21.4% (3/14), p=0.040), the absence of ascites (benign vs life-threatening = 79.1% (19/24):40.0% (6/15), p=0.019) and patient age (benign vs life-threatening = 52.5±65.3 months vs 19.7±44.0 months, p=0.019). No significant difference was observed in the location of PVG in the liver, the presence of free air, and sex between the two groups.
In pediatric patients with PVG, including various ages and underlying diseases, intestinal pneumatosis limited to the large bowel and absence of ascites were predictors of a benign prognosis. However, despite the presence of these predictors, some patients with PVG required surgical intervention, therebysuggesting that the cause of PVG, such as necrotizing enterocolitis, volvulus, or pancreatitis, must be also carefully evaluated.
评估超声检查结果，以确定超声检测出门静脉气体（PVG）的儿科患者预后的潜在预测指标。
纳入39名儿童，分为两组：良性PVG组（n = 24）和危及生命的PVG组（n = 15；6例行手术干预，9例死亡）。比较两组间可能的预测指标，即PVG在肝脏中的位置、肠积气的分布、腹水和游离气体情况。
两组在肠积气分布（局限于大肠，良性组与危及生命组 = 60.9%（14/23）:21.4%（3/14），p = 0.040）、无腹水（良性组与危及生命组 = 79.1%（19/24）:40.0%（6/15），p = 0.019）及患者年龄（良性组与危及生命组 = 52.5±65.3个月 vs 19.7±44.0个月，p = 0.019）方面存在显著差异。两组在PVG在肝脏中的位置、游离气体的存在情况及性别方面未观察到显著差异。
在患有PVG的儿科患者中，包括不同年龄和基础疾病，局限于大肠的肠积气和无腹水是良性预后的预测指标。然而，尽管存在这些预测指标，一些PVG患者仍需要手术干预，这表明还必须仔细评估PVG的病因，如坏死性小肠结肠炎、肠扭转或胰腺炎。
