Amenu Eunice, Karim Sahar, Da Silva Rafael C
Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.
School of Medicine, Universidade Para o Desenvolvimento do Alto Vale do Itajaí, Rio do Sul, BRA.
Cureus. 2022 Apr 20;14(4):e24313. doi: 10.7759/cureus.24313. eCollection 2022 Apr.
Hepatic portal venous gas (HPVG) is a condition where air embolization from disrupted intestinal mucosa reaches the portal system. It is an uncommon finding and denotes severity. This report describes HPVG as a rare and lethal complication of enteral nutrition. The patient had a history of pancreatic adenocarcinoma (PADC) managed with Whipple's surgery, complicated with poor oral intake, requiring percutaneous jejunostomy. Subsequently, the patient presented with severe abdominal pain and distension. On imaging, he was found to have diffuse pneumatosis intestinalis (PI) and HPVG. The patient underwent exploratory laparotomy with intraoperative findings of bowel ischemia starting at the distal point of the enteral tube feeding. Despite aggressive intensive support, the patient died. The aim of this case description is to highlight a rare complication of enteral feeding with impressive imaging findings. Intensive care providers should consider this complication in patients with acute abdominal symptoms, who are under enteral feeding.
肝门静脉积气（HPVG）是一种因肠黏膜破裂导致空气栓塞进入门静脉系统的病症。它是一种罕见的发现，提示病情严重。本报告将HPVG描述为肠内营养罕见且致命的并发症。该患者有胰腺腺癌（PADC）病史，接受了惠普尔手术，术后出现经口摄入不良，需行经皮空肠造口术。随后，患者出现严重腹痛和腹胀。影像学检查发现他患有弥漫性肠壁积气（PI）和HPVG。患者接受了剖腹探查术，术中发现肠缺血始于肠内管饲的远端。尽管给予了积极的重症支持，患者仍死亡。本病例描述的目的是强调肠内喂养罕见的并发症以及令人印象深刻的影像学表现。重症监护人员应考虑到接受肠内喂养且有急性腹部症状患者的这一并发症。
