Surgical Indication of Hepatic Portal Venous Gas. Our Experiences of 12 Cases.
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- Kanamaru Hitoshi
- Department of Surgery, Fujieda Municipal General Hospital
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- Yokoyama Hidetarou
- Department of Surgery, Fujieda Municipal General Hospital
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- Shirakawa Motoaki
- Department of Surgery, Fujieda Municipal General Hospital
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- Hashimoto Harumitsu
- Department of Surgery, Fujieda Municipal General Hospital
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- Yoshino Goro
- Department of Surgery, Fujieda Municipal General Hospital
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- Takatsu Akira
- Department of Surgery, Fujieda Municipal General Hospital
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- Sugiyama Ko
- Department of Ultrasound, Fujieda Municipal General Hospital
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- Akiyama Toshikazu
- Department of Ultrasound, Fujieda Municipal General Hospital
Bibliographic Information
- Other Title
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- 門脈ガス血症の手術適応 本症12例の経験から
- Our Experiences of 12 Cases
- 本症12例の経験から
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Abstract
While hepatic portal venous gas (HPVG) is considered a poor prognostic condition requiring emergency laparotomy, many cases have been reported to recover spontaneously without surgical intervention, making surgical indication controversial. We report 12 cases of HPVG, focusing on indications for emergency laparotomy. Materials and Methods: We clinically compared 2 groups, -5 patients with intestinal necrosis (group A), 7 without (group B). Results: All group A patients were in poor general condition with abdominal rigidity, while group B patients had good general condition with abdominal muscle guarding in only 1 case. All group A patients had fever, while 4 in group B were fever-free. White blood cell counts (WBC) exceeded 10, 000/mm3 in 5 group A patients, and in 5 group B. C-reactive protein (CRP) exceeded 20 mg/dl in 2 of the group A patients with 4.3mg/dl and 7.0mg/dl in other 2 patients, but was less than 1.1mg/dl in 5 group B patients. Conclusions: Two mechanisms underly HPVG production; gas-producing bacteria such as E. coli, in intestinal necrosis and elevated intestinal pressure in, e.g., nonstrangulated intestinal obstruction. Laparotomy is not assumed necessary in cases of elevated intestinal pressure. Surgical indications for HPVG depend on the existence of intestinal necrosis, determined by clinical signs including general condition, abdominal status, body temperature, etc. Physical examination is as important as in other acute abdomen disorders. In laboratory data, CRP is more helpful than WBC in deciding surgical indications.
Journal
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- The Japanese Journal of Gastroenterological Surgery
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The Japanese Journal of Gastroenterological Surgery 35 (8), 1369-1376, 2002
The Japanese Society of Gastroenterological Surgery
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Details 詳細情報について
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- CRID
- 1390001204915615744
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- NII Article ID
- 130004343789
- 110001344279
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- NII Book ID
- AN00192066
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- ISSN
- 13489372
- 03869768
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed