Ulus Travma Acil Cerrahi Derg. 2006; 12(2): 167-169

Hepatic portal venous gas: a case report

Osman Yüksel¹, Mustafa Þare¹, Bülent Salman¹, Oktay Ýrkörücü², Tugan Tezcaner¹, Öge Taþçýlar¹, Nusret Akyürek¹, Ertan Tatlýcýoðlu^1
1Department Of General Surgery, Medicine Faculty Of Gazi University, Ankara, Turkey
²Medicine Faculty Of Gazi University; Specialist, Ankara, Turkey

Gas in hepatic portal vein is a rare entity. This may be apparent after mesenteric ischemia, blunt abdominal trauma, intestinal obstruction, and intra-abdominal infection. Intrahepatic gas was detected by direct abdominal graphy in a 58 year-old man who was admitted to our emergency service with acute abdomen. On computed tomography; portal vein gas, pneumatosis intestinalis, and occlusion of superior mesenteric vein and artery were detected. The patient who had had significant concomittant operative risks, died prior to surgery. Gas in portal vein is a good predictive factor for diagnosis, management, and prognosis. This sign may avoid unnecessary surgery and also it may help to make an early decision for surgery.

Keywords: Portal vein/radiography, prognosis, retrospective studies; survival rate; tomography, X-ray computed

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Hepatik portal vende gaz: Olgu sunumu

Osman Yüksel¹, Mustafa Þare¹, Bülent Salman¹, Oktay Ýrkörücü², Tugan Tezcaner¹, Öge Taþçýlar¹, Nusret Akyürek¹, Ertan Tatlýcýoðlu^1
1Gazi Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý, Ankara, Türkiye
²Gazi Üniversitesi Týp Fakültesi Serbest Hekim, Ankara, Türkiye

Hepatik portal vende gaz (HPVG) çok ender görülür. Mezenterik iskemi, künt karýn travmalarý, baðýrsak týkanýklýðý ve karýniçi enfeksiyonlar sonucu oluþabilir. Acil servise baþvuran 58 yaþýnda erkek hasta akut karýn bulgularý ile deðerlendirilirken ayakta çekilen direkt karýn grafisinde intrahepatik olabileceði düþünülen gaz saptandý. Bilgisayarlý tomografi incelemesinde ana portal ven ve dallarýnda gaz, pnömatozis intestinalis, süperior mezenterik ven ve arterde oklüzyon saptandý. Cerrahi riski yüksek olan hasta ameliyattan önce kaybedildi. Bu yazýda, HPVG’nin hastalýðýn taný, tedavi ve seyri hakkýnda yüksek doðrulukta yardýmcý olabileceði, gereksiz cerrahi tedaviyi önleyebileceði, erken cerrahi tedaviye karar vermede yardýmcý olabileceði vurgulandý.

Anahtar Kelimeler: Portal ven/radyografi, prognoz; retrospektif çalýþma; saðkalým oraný; tomografi, X-ýþýný kompüterize

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