PDF(Pubmed)
Abstract：
Hepatic portal venous gas is often referred to as the \"sign of death\" because it signifies a very poor prognosis if appropriate treatments are not promptly administered. The etiologies of hepatic portal venous gas are diverse and include severe complex abdominal infections, mesenteric ischemia, diving, and complications of endoscopic surgery, and the clinical manifestations are inconsistent among individual patients. Thus, whether emergency surgery should be performed remains controversial. In this report, we present three cases of hepatic portal venous gas. The patients initially exhibited symptoms consistent with severe shock of unknown etiology and were treated in the intensive care unit upon admission. We rapidly identified the cause of each individual patient\'s condition and selected problem-directed intervention measures based on active organ support, antishock support, and anti-infection treatments. Two patients recovered and were discharged without sequelae, whereas one patient died of refractory infection and multiple organ failure. We hope that this report will serve as a valuable reference for decision-making when critical care physicians encounter similar patients.
摘要：
肝门静脉气体通常被称为“死亡迹象”，因为如果不及时进行适当的治疗，它意味着预后非常差。肝门静脉气体的病因多种多样，包括严重的复杂的腹部感染，肠系膜缺血,潜水,以及内窥镜手术的并发症，且个别患者的临床表现不一致。因此，是否应进行急诊手术仍存在争议.在这份报告中,我们介绍了3例肝门静脉气体。患者最初表现出与病因不明的严重休克一致的症状，入院后在重症监护病房接受治疗。我们迅速确定了每个患者病情的原因，并根据积极的器官支持选择了以问题为导向的干预措施，抗冲击支撑,和抗感染治疗。两名病人痊愈出院,无后遗症,而1例患者死于难治性感染和多器官功能衰竭。我们希望这份报告能够为重症监护医师遇到类似患者时的决策提供有价值的参考。
