門脈内ガス血症を呈した胃潰瘍穿孔の1例

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  • A CASE OF HEPATIC PORTAL VENOUS GAS ASSOCIATED WITH PERFORATED GASTRIC ULCER

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A 42-year-old man was seen at the hospital because of severe abdominal pain. Panperitonitis due to perforation of the gastrointestinal tract with hepatic portal venous gas (HPVG) was diagnosed on radiological and physical examinations. He underwent on emergency subtotal gastrectomy. The postoperative course was uneventful and hepatic portal venous gas disappeared on the 5th postaperative day. He was discharged from the hospital on the 14th day after the operation.<br> HPVG is believed to be a sign of severe intestinal necrosis. With a recent widespread use of various imaging methods, even small quantity of gas can be visualized with a resultant increase in reports of HPVG which are of less clinical significance. However, we think that such cases of HPVG with good prognosis are few and HPVG is still an important sign suggestive of intraabdominal catastrophes, though it is rare. Once HPVG is noticed, careful and appropriate treatment would be mandatory.

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