| 000 | 01625cam a2200181 4500 | ||
|---|---|---|---|
| 001 | NMDX7623 | ||
| 008 | 120401t2017 xxu||||| |||| 00| 0 eng d | ||
| 100 | _aBernstein, B.S. | ||
| 240 | _aJournal of Surgical Case Reports | ||
| 245 | _aHepatic portal venous gas: acute deterioration in an elderly patient | ||
| 260 | _c2017 | ||
| 500 | _aNMUH Staff Publications | ||
| 520 | _a<span style="font-size: 10pt;"><span style="font-family: arial, helvetica, clean, sans-serif; text-align: left;">A 91-year-old female presented to the Emergency Department with a 10-day history of constipation and abdominal pain. Abdominal examination was normal and rectal examination showed faecal loading. A phosphate enema was given and the patient was admitted. Overnight, the patient's GCS dropped from 15/15 to 3/15 and an arterial blood gas showed a lactate of 8 mmol/L (1.5 on admission). Abdomen remained soft throughout. A CT scan showed a large amount of free air and free fluid within the abdomen and pelvis, highly suspicious for perforation. Hepatic portal venous gas (HPVG) was visible, with portal venous air fluid levels noted. The patient was treated palliatively and died shortly thereafter. HPVG is a recognized but rarely identified radiological sign, which is a poor prognostic indicator, with most cases subsequently proving terminal, often due to subsequent bowel necrosis.</span>&nbsp;</span> | ||
| 700 | _aCallan, R.G. | ||
| 700 | _aPampiglione, T. | ||
| 856 | _uhttps://www.ncbi.nlm.nih.gov/pubmed/29250315 | ||
| 856 | _uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5724020/pdf/rjx245.pdf | ||
| 999 |
_c76460 _d76460 |
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