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机械通气后以小肠梗阻而非肠缺血表现的肠壁积气症

Pneumatosis Intestinalis Presenting as Small Bowel Obstruction without Bowel Ischemia after Mechanical Ventilation.

作者信息

Kim Dong Joon, Choi Yong Joon, Yoo Young Sun

机构信息

Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea.

Department of Surgery, Chosun University Hospital, Gwangju, Korea.

出版信息

Acute Crit Care. 2019 Feb;34(1):81-85. doi: 10.4266/acc.2016.00311. Epub 2017 Jan 17.

Abstract

Pneumatosis intestinalis (PI) is a rare condition of the presence of gas within the bowel walls. PI is associated with numerous underlying diseases, ranging from life-threatening to innocuous conditions. PI is believed to be secondary to coexisting disorders in approximately 85% of all cases. This paper reviews the case of a patient who was diagnosed 7 years prior with pneumoperitoneum from unknown causes without any symptoms. The patient was admitted to the intensive care unit for the management of aspiration pneumonia and developed extensive PI after mechanical ventilation, presenting as small bowel obstruction with mesenteric torsion. Although the exact mechanism and etiology of PI are unclear, this case provides an update on the imaging features of and the clinical conditions associated with PI, as well as the management of this condition.

摘要

肠壁积气(PI)是一种罕见的肠壁内存在气体的病症。PI与众多潜在疾病相关,从危及生命的疾病到无害病症都有。在所有病例中,约85%的PI被认为是继发于并存疾病。本文回顾了一名7年前因不明原因诊断为气腹且无症状的患者的病例。该患者因吸入性肺炎入住重症监护病房,机械通气后出现广泛的PI,表现为伴有肠系膜扭转的小肠梗阻。尽管PI的确切机制和病因尚不清楚,但该病例提供了关于PI的影像学特征、相关临床情况以及该病症管理的最新信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a96/6849051/d96317f0856d/acc-2016-00311f1.jpg

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