PDF(Pubmed)
Abstract：
UNASSIGNED: Hepatic portal venous gas is a rare and life-threatening condition characterised by the presence of gas in the portal vein. Hepatic portal venous gas is frequently associated with intestinal ischaemia and necrosis. We present the case of a paediatric patient with acute appendicitis with hepatic portal venous gas detected using ultrasonography.
UNASSIGNED: A 5-year-old boy was admitted to our hospital with a respiratory tract infection. The boy started vomiting on day 2 of hospitalisation. He did not complain of any symptoms due to developmental retardation. We performed bedside point-of-care ultrasound, which detected hepatic portal venous gas, although the appendix could not be detected due to an acoustic shadow associated with bowel gas. Contrast-enhanced computed tomography revealed perforated appendicitis and pneumatosis intestinalis associated with paralytic ileus. An emergency laparoscopic appendectomy was performed. He was discharged on day 25 of hospitalisation after antibiotic therapy.
UNASSIGNED: The present case suggests that the mechanism of hepatic portal venous gas was paralytic ileus, which caused gas-forming bacterial proliferation. The gas produced by bacteria and/or the gas-forming bacteria entered the bowel wall, which caused pneumatosis intestinalis. The bubbles in the intestinal wall floated in the portal system and were detected as hepatic portal venous gas. Perforated appendicitis and paralytic ileus seemed to be caused by a delayed diagnosis of appendicitis. The point-of-care ultrasound examination was useful for detecting hepatic portal venous gas and for helping establish the diagnosis of appendicitis.
UNASSIGNED: Hepatic portal venous gas is a rare finding associated with appendicitis in children. In addition, point-of-care ultrasound is useful for detecting hepatic portal venous gas in paediatric patients.
UNASSIGNED: A 5-year-old boy was admitted to our hospital with a respiratory tract infection. The boy started vomiting on day 2 of hospitalisation. He did not complain of any symptoms due to developmental retardation. We performed bedside point-of-care ultrasound, which detected hepatic portal venous gas, although the appendix could not be detected due to an acoustic shadow associated with bowel gas. Contrast-enhanced computed tomography revealed perforated appendicitis and pneumatosis intestinalis associated with paralytic ileus. An emergency laparoscopic appendectomy was performed. He was discharged on day 25 of hospitalisation after antibiotic therapy.
UNASSIGNED: The present case suggests that the mechanism of hepatic portal venous gas was paralytic ileus, which caused gas-forming bacterial proliferation. The gas produced by bacteria and/or the gas-forming bacteria entered the bowel wall, which caused pneumatosis intestinalis. The bubbles in the intestinal wall floated in the portal system and were detected as hepatic portal venous gas. Perforated appendicitis and paralytic ileus seemed to be caused by a delayed diagnosis of appendicitis. The point-of-care ultrasound examination was useful for detecting hepatic portal venous gas and for helping establish the diagnosis of appendicitis.
UNASSIGNED: Hepatic portal venous gas is a rare finding associated with appendicitis in children. In addition, point-of-care ultrasound is useful for detecting hepatic portal venous gas in paediatric patients.
摘要：
■肝门静脉气体是一种罕见且危及生命的疾病，其特征是门静脉中存在气体。肝门静脉气体通常与肠缺血和坏死有关。我们介绍了一例小儿急性阑尾炎患者，并使用超声检查检测到肝门静脉气体。
■一名5岁男孩因呼吸道感染入院。男孩在住院的第二天开始呕吐。他没有因发育迟缓而抱怨任何症状。我们做了床边点护理超声,检测到肝门静脉气体，尽管由于与肠气相关的声影而无法检测到阑尾。对比增强计算机断层扫描显示穿孔性阑尾炎和肠梗阻伴麻痹性肠梗阻。进行了紧急腹腔镜阑尾切除术。他在抗生素治疗后住院第25天出院。
■本病例提示肝门静脉气体的发病机制为麻痹性肠梗阻，导致气体形成的细菌增殖。细菌产生的气体和/或气体形成细菌进入肠壁，导致肠肌积气。肠壁中的气泡漂浮在门静脉系统中，并被检测为肝门静脉气体。穿孔性阑尾炎和麻痹性肠梗阻似乎是由阑尾炎的延迟诊断引起的。即时超声检查可用于检测肝门静脉气体并帮助建立阑尾炎的诊断。
■肝门静脉气体是与儿童阑尾炎相关的罕见发现。此外,护理点超声可用于检测儿科患者的肝门静脉气体。
■一名5岁男孩因呼吸道感染入院。男孩在住院的第二天开始呕吐。他没有因发育迟缓而抱怨任何症状。我们做了床边点护理超声,检测到肝门静脉气体，尽管由于与肠气相关的声影而无法检测到阑尾。对比增强计算机断层扫描显示穿孔性阑尾炎和肠梗阻伴麻痹性肠梗阻。进行了紧急腹腔镜阑尾切除术。他在抗生素治疗后住院第25天出院。
■本病例提示肝门静脉气体的发病机制为麻痹性肠梗阻，导致气体形成的细菌增殖。细菌产生的气体和/或气体形成细菌进入肠壁，导致肠肌积气。肠壁中的气泡漂浮在门静脉系统中，并被检测为肝门静脉气体。穿孔性阑尾炎和麻痹性肠梗阻似乎是由阑尾炎的延迟诊断引起的。即时超声检查可用于检测肝门静脉气体并帮助建立阑尾炎的诊断。
■肝门静脉气体是与儿童阑尾炎相关的罕见发现。此外,护理点超声可用于检测儿科患者的肝门静脉气体。
