14 KB166 KB12 KB199220252004Gregorič, PrimožVišnar-Perovič, Alenkaletnik:38številka:44 stranistr. 329-332ISSN:1318-2099COBISSID:19026905URN:URN:NBN:SI:doc-9O1SY8BQenAssociation of Radiology and OncologyRadiology and oncology (Ljubljana)AgeddiagnostikaEmbolija zračnaEmbolism, AirPortal VeinPortalna venaStarostnikiUltrasonografija dopplerskaUltrasonographyUltrasonography, Dopplerultrazvočna diagnostikaClinical importance of portal venous gas detected by abdominal sonography| a report of two cases|Background. Portal venous gas (PVG) can be a sign of serious disease and a predictor of poor clinical outcome. However, it ean also occur as a transient phenomenon with little clinical significance, especially following blunt abdominal trauma and various diagnostic and therapeutic procedures. Case reports. We describe two patients with PVG detected on abdominal sonography, who had very similar sonographic findings but a completely different clinical outcome. The first patient was a 70-year-old man in whom PVG was the consequence of mesenteric infarction; the patient died in hospital shortly after the admission. Our second patient was a 26-year-old man who was injured in a motor vehicle accident. He was clinically stable and needed no aggressivetreatment. PVG proved to be a transient phenomenon that cleared spontaneously within a day. Conclusions. Doppler sonography is a sensitive andspecific modality for the detection of PVG. In patients with a serious underlying disease, sonography can identify the cause of PVG, so that the appropriate therapy may be undertaken without delay. If the aetiology is unclear, the decision to undertake further expensive and potentially harmful diagnostic procedures should be based on the patient's clinical statusIzhodišča. Dokaz plina v veni porte je ponavadi znak resnega obolenja v trebuhu in pomeni slabo prognozo. Z napredkom ultrazvočne diagnostike v zadnjih letih odkrijemo zrak v portalni veni tudi kot prehoden pojav brez kliničnih posledic in sicer pri topi poškodbi trebuha in nekaterih diagnostičnih in terapevtskih postopkih. Prikaz primerov. Predstavljamo dva bolnika. Obema smo pri ultrazvočni preiskavi trebuha odkrili znake plina v portalnih venah, potek bolezni pa je bil diametralno nasproten. Prvi bolnik jebil star 70 let. Utrpel je infarkt mezenterija, čigar posledica je bil plin v portalnih venah. Umrl je nekaj ur po prihodu v bolnišnico. Drugi bolnik je bil star 26 let. Poškodovan je bil kot voznik v prometni nesreči. Med hospitalizacijo je bil klinično stabilen in ni potreboval invazivnega zdravljenja. Ugotovili smo, da se je pojavil plin v portalni veni prehodno zaradi tope poškodbe trebuha. Zaključki. Ultrazvočna preiskava trebuha z uporabo Dopplerja je občutljiva in specifična metoda za dokaz plina v portalnih venah. Z ultrazvočno preiskavo lahko tudi odkrijemo obolenje v trebuhu, ki je vzrok za ta pojav in skrajšamo čas do potrebnega zdravljenja. Če z ultrazvočno preiskavo ne odkrijemo jasnega vzroka za plin v portalnih venah, se moramo o nadaljnih, potencialno nevarnih diagnostičnih in terapevtskih postopkih odločati glede na klinično sliko, ker je pojav plina v portalnih venah lahko tudi prehodnega značajaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaDruštvo radiologije in onkologije