一名71岁的男性患者在被诊断为多发性小中风八天后再次入院,怀疑有轻微的癫痫发作,并抱怨腹泻和腹痛。病人情况稳定,不发热,神经完整,左下象限有轻微压痛。超声检查显示肝门静脉系统中存在空气,并怀疑乙状结肠憩室炎。CT扫描证实了这两种诊断。我们在密切观察下进行了保守治疗。临床病程及实验室检查结果无明显差异。
结论:文献综述(PubMed数据库)触发了685个项目,只有一个临床试验建立了一个评分系统来检测成人个体,需要操作。
结论:肺通图(肝门静脉气体,HPVG)是一种非常罕见的,通常与肠缺血和预后不良有关。在过去的几十年中,出现了许多其他病因(也是良性的),范式从系统的紧急开腹手术转变为个体患者选择。
UNASSIGNED: Eight days after being diagnosed with multiple small strokes a 71year old male patient is readmitted with suspicion of a petit mal seizure also complained of diarrhoea and abdominal pain. The patient was stable, not febrile and neurologically intact with a slight tenderness in the left lower quadrant. An ultrasound revealed presence of air in the hepatic portal venous system and a suspicion for sigmoid diverticulitis. A CT-scan confirmed both diagnoses. We proceeded with a conservative regimen under close observation. The clinical course and laboratory results were unremarkable.
CONCLUSIONS: The review of the literature (PubMed database) triggered 685 items with only one clinical trial establishing a scoring system to detect adult individuals, which need operation.
CONCLUSIONS: A
pneumoportogram (hepatic portal venous gas, HPVG) is a very rare and usually associated with bowel ischemia and from poor prognosis. The last decades saw the emergence of numerous other aetiologies (also benign) with a shift of paradigm from systematic emergency laparotomies to individual patient selection.