• Bmc Gastroenterol · Jan 2011

    High APACHE II score and long length of bowel resection impair the outcomes in patients with necrotic bowel induced hepatic portal venous gas.

    • Jin-Ming Wu, Ming-Shian Tsai, Ming-Tsan Lin, Yu-Wen Tien, and Tzu-Hsin Lin.
    • Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
    • Bmc Gastroenterol. 2011 Jan 1;11:18.

    BackgroundHepatic portal venous gas (HPVG) is a rare but potentially lethal condition, especially when it results from intestinal ischemia. Since the literatures regarding the prognostic factors of HPVG are still scarce, we aimed to investigate the risk factor of perioperative mortality in this study.MethodsWe analyzed data for patients with intestinal ischemia induced HPVG by chart review in our hospital between 2000 and 2007. Factors associated with perioperative mortality were specifically analyzed.ResultsThere were 22 consecutive patients receiving definite bowel resection. 13 cases (59.1%) died after surgical intervention. When analyzing the mortality in patients after bowel resections, high Acute Physiology And Chronic health Evaluation (APACHE) II score (p<0.01) and longer length of bowel resection (p=0.047) were significantly associated with mortality in univariate analyses. The complication rate was 66.7% in alive patients after definite bowel resection.ConclusionsBowel resection was the only potential life-saving therapy for patients with mesenteric ischemia induced HPVG. High APACHE II score and severity of underlying necrotic bowel determined the results in patients after bowel resection.

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