Di Capua Mirko, Tonani Michela, Paglia Stefano
Emergency Department, "Maggiore" Hospital of Lodi, Largo Donatori del Sangue, 1, 26900 Lodi, Italy.
Emergency Department, "Guglielmo da Saliceto" Hospital of Piacenza, Via Giuseppe Taverna, 49, 29121 Piacenza, Italy.
Case Rep Crit Care. 2022 Aug 23;2022:1734612. doi: 10.1155/2022/1734612. eCollection 2022.
Acute bowel ischemia is a severe disease often with a poor outcome. Early diagnosis can improve outcome, but atypical clinical manifestations and nonspecific laboratory and instrumental diagnostic findings may delay computed tomographic angiography (CTA). Portomesenteric venous gas (PVG), indirect sign of pneumatosis intestinalis, is considered a late finding with poor prognosis. We report four cases where PVG, easily identified through point-of-care ultrasonography (POCUS), was an early sign of bowel ischemia leading to a precocious diagnosis confirmed at CTA. In acute non-traumatic abdominal pain, an evidence of PVG could be an early ultrasonographic finding of bowel ischemia in the emergency department.
急性肠缺血是一种严重疾病，预后通常较差。早期诊断可改善预后，但非典型临床表现以及非特异性实验室和影像学诊断结果可能会延迟计算机断层血管造影（CTA）检查。门静脉积气（PVG）是肠壁积气的间接征象，被认为是预后不良的晚期表现。我们报告了4例病例，其中通过床旁超声检查（POCUS）易于识别的PVG是肠缺血的早期征象，从而实现了在CTA检查时确诊的早熟诊断。在急性非创伤性腹痛中，PVG的存在可能是急诊科肠缺血的早期超声表现。
