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Risk factors for bowel necrosis in patients with hepatic portal venous gas.
MedLine Citation:
PMID:  24880671     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To evaluate the risk factors for bowel necrosis in adult patients with hepatic portal venous gas (HPVG).
METHODS: This retrospective study comprised 33 adult patients treated for HPVG between August, 2008 and December, 2011. The patients were divided into a necrotic group (n = 14) and a non-necrotic group (n = 19). We analyzed the clinical demographics, laboratory data, multi-detector computed tomography findings, treatments, and outcomes in each group.
RESULTS: Abdominal pain, peritoneal signs, systolic blood pressure, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase (LDH), small intestinal dilatation, poor enhancement of the bowel wall, and intestinal pneumatosis were all significantly associated with bowel necrosis. Moreover, there were significantly more operative cases and deaths in the necrotic group. Multivariate analysis revealed that systolic BP (p = 0.048), LDH (p = 0.022), and intestinal pneumatosis (p = 0.038) were independent risk factors for bowel necrosis. Thus, we created new diagnostic criteria for bowel necrosis based on these three factors, the sensitivity, specificity, and accuracy of which were 100, 78.9, and 87.9 %, respectively.
CONCLUSIONS: This study demonstrates new and important findings to evaluate the risk factors for bowel necrosis. Using our diagnostic criteria, the indications for emergency laparotomy can be established more accurately.
Authors:
Hiroyuki Koami; Tsutomu Isa; Tomonari Ishimine; Shinichiro Kameyama; Toshinobu Matsumura; Kosuke Chris Yamada; Yuichiro Sakamoto
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-1
Journal Detail:
Title:  Surgery today     Volume:  -     ISSN:  1436-2813     ISO Abbreviation:  Surg. Today     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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