Liu Youshun, Li Yong, Zhu Chunping, Liu Haifeng, Huang Ji
Department of Gastroenterology, Xinfeng People's Hospital, China.
Department of Gastroenterology, Ganzhou People's Hospital, China.
J Int Med Res. 2025 Jun;53(6):3000605251340529. doi: 10.1177/03000605251340529. Epub 2025 Jun 10.
We reported a case of portal vein pneumatosis caused by a nasojejunal nutrition tube that was successfully treated conservatively. This patient was discharged after 1 week of treatment with imipenem/cilastatin sodium for anti-infection, gastrointestinal decompression, fluid replacement, and pain relief, and the patient's abdominal pain was significantly relieved. The main pathogenesis of hepatic portal venous gas is as follows: (a) increased pressure in the digestive tract leading to gas entering the portal vein circulation through the intestinal wall and finally into the liver; (b) destruction of the intestinal mucosa causing the gas formed by intestinal bacteria to enter the portal vein system; and (c) diffusion of gas produced by bacteria in intraperitoneal abscesses or portal vein and mesentery, causing pyelitis. The successful treatment of this patient highlights that addressing physical factors, providing gastrointestinal decompression, and administering anti-infection therapy can aid in the management of such cases. Bacterial culture of gastric juice and drug sensitivity testing can guide effective anti-infection treatment.
我们报告了一例由鼻空肠营养管引起的门静脉积气病例，该病例经保守治疗成功治愈。该患者在接受亚胺培南/西司他丁钠抗感染、胃肠减压、补液及止痛治疗1周后出院，腹痛明显缓解。肝门静脉积气的主要发病机制如下：(a)消化道压力升高导致气体通过肠壁进入门静脉循环，最终进入肝脏；(b)肠黏膜破坏导致肠道细菌产生的气体进入门静脉系统；(c)腹腔脓肿或门静脉及肠系膜中细菌产生的气体扩散，导致肾盂炎。该患者的成功治疗突出表明，解决物理因素、进行胃肠减压和给予抗感染治疗有助于此类病例的管理。胃液细菌培养和药敏试验可指导有效的抗感染治疗。
