[Hepatic portal venous gas: surgery or not surgery?]

Ann Fr Anesth Reanim. 2013 Nov;32(11):803-6. doi: 10.1016/j.annfar.2013.08.005. Epub 2013 Oct 23.
[Article in French]

Abstract

Finding hepatic portal venous gas with pneumatosis intestinalis on computed tomography (CT) represents diagnostic and therapeutic challenge. The intestinal necrosis, particularly associated with acute mesenteric ischemia, is the very first hypothesis to assess, with the underlying question of an urgent surgery. However, knowing the non-surgical causes that have been identified in the last decade seems necessary to better assess the risk-benefit ratio of emergency surgery. Among these causes, we report the case of the acute colonic pseudo-obstruction, also known as Ogilvie's syndrome, whose first line treatment is medical.

Keywords: Acute colonic pseudo-obstruction; Aéroportie; Colectasie primitive; Pneumatose pariétale; Pneumatosis intestinalis; Portal venous gas.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Colonic Diseases / etiology
  • Embolism, Air / diagnosis*
  • Embolism, Air / surgery*
  • Fatal Outcome
  • Female
  • Gastroparesis / complications
  • Gastroparesis / therapy
  • Haemophilus Infections / complications
  • Haemophilus influenzae
  • Humans
  • Intestinal Diseases / complications
  • Intestinal Diseases / pathology
  • Intestinal Diseases / surgery
  • Intestinal Pseudo-Obstruction / diagnosis
  • Intestinal Pseudo-Obstruction / surgery
  • Ischemia
  • Mesenteric Ischemia
  • Middle Aged
  • Multiple Organ Failure / complications
  • Necrosis
  • Portal Vein / surgery*
  • Risk Assessment
  • Tomography, X-Ray Computed
  • Vascular Diseases

Substances

  • Anti-Bacterial Agents