潜水后发生大量门静脉气体栓塞
Massive portal venous gas embolism after scuba diving.
作者信息
Siaffa Romain, Luciani Marc, Grandjean Bruno, Coulange Mathieu
机构信息
Navy Medical Department, Naval base of Toulon, Toulon, France.
Corresponding author: Romain Siaffa, Sainte-Anne Military Hospital, 2 Boulevard Sainte Anne, 83000 Toulon, France,
出版信息
Diving Hyperb Med. 2019 Mar 31;49(1):61-63. doi: 10.28920/dhm49.1.61-63.
INTRODUCTION
Portal venous gas from a diving injury is an infrequent finding and only a few cases are described. We report a case of severe decompression sickness (DCS) associated with a massive amount of gas in the portal and mesenteric veins.
CASE REPORT
A 49-year-old man suffered from DCS after two deep dives on the same day. He presented with cutaneous, neurological and pulmonary symptoms associated with hypoxaemia. He had no abdominal pain. A computed tomography (CT) scan showed large quantities of hepatic and portal venous gas and excluded other explanations for its presence. All symptoms disappeared with hyperbaric oxygen therapy and there were no further complications.
DISCUSSION AND CONCLUSION
The role of portal venous gas in DCS is not obvious. Isolated portal venous gas seems to cause no obvious harm. Medical imaging should be considered for differential diagnosis and to prevent some complications, especially in divers presenting with abdominal pain.
引言
潜水损伤导致的门静脉气体是一种罕见的发现，仅有少数病例被描述。我们报告一例与门静脉和肠系膜静脉大量气体相关的严重减压病（DCS）病例。
病例报告
一名49岁男性在同一天进行两次深潜后患上减压病。他出现了与低氧血症相关的皮肤、神经和肺部症状。他没有腹痛。计算机断层扫描（CT）显示肝脏和门静脉有大量气体，并排除了其他导致气体出现的原因。经高压氧治疗后所有症状消失，且未出现进一步并发症。
讨论与结论
门静脉气体在减压病中的作用尚不明确。孤立的门静脉气体似乎不会造成明显损害。应考虑进行医学成像检查以进行鉴别诊断并预防一些并发症，特别是对于出现腹痛的潜水员。
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