在透析患者中暂时的扩展性门静脉气
Michael J Martinez1, John J Murphy2, Francisco R Halili3
1Radiology, St. Matthew's University, Grand Cayman, CYM.
Cureus
|December 1, 2025
概括
肝门静脉气 (HPVG) 可能是肠道缺血的一个错误警报. 这个案例显示HPVG在没有手术的情况下得到解决,突出显示需要将成像与临床发现相关联.
科学领域:
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 肝门静脉气 (HPVG) 是一种令人担忧的放射性征兆,通常与肠道缺血有关.
- CT技术的进步导致过渡性HPVG的检测更频繁,有时没有相关的缺血症.
研究的目的:
- 在接受血液透析的末期病患者 (ESRD) 中报告HPVG病例.
- 强调将成像检测结果与临床表现和手术结果相结合的重要性.
主要方法:
- 一名70岁的女性患者患有ESRD,接受血液透析,呈现出急性腹痛.
- 计算机断层扫描 (CT) 显示HPVG扩展到上层介质静脉系统.
- 由于担心缺血症,进行了紧急的诊断性腹腔镜检查.
主要成果:
- 腹腔镜检查显示肠道组织健康,没有亡或穿孔的迹象.
- 通过支持性护理,患者的情况有所改善.
- 48小时后的后续CT扫描显示HPVG完全消失.
结论:
- 在CT扫描中检测到的HPVG需要与临床状态和手术发现进行仔细的相关性.
- 对于HPVG患者,当临床和外科评估排除肠道缺血时,非手术治疗可能是适当的.
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