Hepatic-portal venous gas embolism due to liver abscess rupture

Autori:

Luka Đudarić, Nataša Katavić, Renata Huzjan Korunić, Boris Brkljačić

Sažetak
U ovome radu prikazujemo bolesnicu u kliničkoj slici akutnog abdomena koja se razvila zbog rupture apscesa jetre s posljedicom plinske embolije u sustavu portalne vene te doprinos i mogućnosti radiološke dijagnostike u hitnoj bolničkoj obradi. U etiopatogenetskoj podlozi kolangitisa i razvoja apscesa jetre utvrđena je kronična bilijarna litijaza s intermitentnim opstrukcijama u hepatoduodenalnoj cirkulaciji žuči. Anatomske karakteristike sustava portalne vene i njegovih anastomoza sa sistemskom cirkulacijom predstavljaju supstrat za razvoj ozbiljnih posljedica plinske embolije na drugim organskim sustavima, primjerice, u obliku infarkta bubrega i infarkta slezene, što je radiološkim dijagnostičkim metodama dokazano u ovome slučaju.
Summary

In this paper, we present a female patient with a clinical presentation of acute abdomen that developed due to the rupture of liver abscess and hepatic-portal venous gas embolism. We discuss the contribution of radiological diagnostics in emergency hospital treatment. The etiopathogenetic background of cholangitis and the development of liver abscess confirmed chronic biliary lithiasis with intermittent obstructions in the hepatoduodenal biliary circulation. The anatomical characteristics of the portal vein system and its anastomoses with systemic circulation represent the substrate for the development of serious gas embolism sequelae on other organ
systems in the form of renal infarction and splenic infarction, which were detected by radiological diagnostic methods in this case.