肝门静脉积气的超声表现及临床意义

Hepatic portal venous gas: sonographic appearance and clinical significance

目的探讨肝门静脉积气的超声表现及临床意义。方法回顾性分析我科4年来超声发现肝门静脉积气的5例患者,分析肝门静脉积气的超声特点及其对临床治疗和预后的影响。结果5例门静脉积气的患者均由超声首先发现,其共同的超声表现为门静脉内随血液流动的气泡样或点状强回声以及肝实质内边界不清的条片状强回声区。5例患者的原发病分别为腹腔脓肿、坏死性小肠结肠炎、肝移植手术和闭合性腹部外伤,根据原发病的不同,其中3例门静脉积气患者进行了手术治疗并痊愈,另2例经保守治疗后出院。结论多种病因可导致肝门静脉积气,超声诊断具有早期、敏感、特异的特点。肝门静脉积气的临床处理根据原发病的不同而不同。

Objective To investigate the sonographic appearance of hepatic portal venous gas and its clinical significance. Methods In a retrospective study of 4 year sonographie examinations, hepatic portal venous gas was found in 5 patients. All their sonographie appearances were reviewed and compared with their medical records with special emphasis on the clinical prognosis. Results Gas in the portal vein confirmed by sonograhpy was accompanied by the following signs： eehogenie, moving loci within the lumen of the portal vein and/or poorly defined, eehogenie speckles within the hepatic parenehyma. The etiologies for portal venous gas included abdominal abscess （n= 1）, neerotizing enteroeolitis （n= 1）, hepatic transplantation （n=l）, and blunt abdominal trauma （n=2）. Three patients underwent operations and the others kept conservative treatments, and they all recovered quickly. Conclusion Hepatic portal venous gas is a rare entity caused by various diseases. Sonographie diagnosis has been shown to be prompt, sensitive, and specific. The treatment of patients with hepatic portal venous gas should be directed to the underlying disease.