Open AccessEvaluation of patients with hepatic portal venous gas who can be treated with conservative therapy
Author(s) -
Higashi Takaaki,
Hayashi Hiromitsu,
Takeyama Hideaki,
Arima Kota,
Taki Katsunobu,
Takamori Hiroshi,
Baba Hideo
Publication year - 2016
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.125
Subject(s) - medicine , vital signs , physical examination , conservative treatment , surgery , mortality rate , portal venous pressure , radiology , portal hypertension , gastroenterology , cirrhosis
Aim Hepatic portal venous gas is an indication for emergency surgery and reportedly has a high mortality rate. However, these days, cases of hepatic portal venous gas associated with milder disease are increasing. In this report, we compared two groups to investigate whether there were any objective indicators for selecting conservative therapy. Methods From J uly 2007 to A ugust 2011, 19 patients with hepatic portal venous gas were evaluated at our hospital. The condition was diagnosed by computed tomography imaging. Vital signs, laboratory test results, and physical examination findings were compared. Results The A group included 12 patients who could be treated with conservative therapy. The B group included 7 patients who could not be treated with conservative therapy. The combined mortality rate was 31.5% (6/19 patients). There was a significant difference in the pulse rate and shock index. In the A group, none of the patients had signs of peritoneal irritation. However, in the B group, physical examination revealed signs of peritoneal irritation in all patients. Conclusion Conservative therapy may be possible in patients with hepatic portal venous gas, depending on the cause. Evaluation of vital signs and serial changes on physical examination are important.