机械性肠梗阻合并肝门静脉积气病例1例

A Case of Mechanical Intestinal Obstruction Combined with Hepatic Portal Vein Gas Accumulation

肝门静脉积气症(hepatic portal venous gas, HPVG)是指由于各种原因导致气体在门静脉及其肝内门静脉分支异常积聚形成的影像学征象,是一种少见的影像学征象。门静脉积气本身是独立的病变,造成门静脉积气的原因有很多,病因不同其预后也不相同。最常见于肠缺血和坏死。一般被认作并发症出现,极其罕见,病情进展极快。肝门静脉积气症的出现往往预示着病情极重,预后较差,病死率极高,常被称为“死神之症”。HPVG的发生、发展及预后常与原发病有关,机械性肠梗阻是指因机械原因如肠腔内、肠壁本身,肠外侧等原因引起的肠内容物不能从上往下运行,出现的肠梗阻。现将河南省人民医院收治的1例机械性肠梗阻合并肝门静脉积气的患者的临床资料及诊治过程报道如下。

Hepatic portal venous gas (HPVG) refers to the imaging signs of abnormal accumulation of gas in the portal vein and its branches in the liver due to various reasons. It is a rare imaging sign. Portal gas itself is an independent lesion. There are many reasons for portal gas, and the prognosis is different with different etiology. It is most common in intestinal ischemia and necrosis. It is generally considered to be a complication, extremely rare, and the disease progresses very quickly. The emergence of hepatic portal gas often indicates a very serious condition, poor prognosis, high fatality rate, often known as “death disease”. The occurrence, development and prognosis of HPVG are often related to the primary disease. Mechanical intestinal obstruction refers to the intestinal obstruction caused by mechanical reasons such as the intestinal cavity, the intestinal wall itself, the intestinal lateral and other reasons that the intestinal contents cannot run from the top down. The clinical data and treatment process of a patient with mechanical ileus complicated with hepatic portal gas admitted to Henan Provincial People’s Hospital are reported as follows.