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腸管気腫症および門脈ガス血症治癒後低血糖を起こした1例
A Patient with Hypoglycemia after Recovery from Pneumatosis Cystoides Intestinalis and Hepatic Portal Venous Gas
麻沼, 和彦
前澤, 毅
小池, 綏男
pneumatosis cystoides intestinalis
腸管気腫症
hepatic portal venous gas
門脈ガス血症
hypoglycemia
低血糖
respiratory arrest
呼吸停止
A 78-year-old man who had malnutrition and Parkinson’s disease vomited. Abdominal X-ray showed a distended stomach,small intestine and colon.Abdominal computed tomography(CT)indicated ascites,hepatic portal venous gas (HPVG), thickened intestinal wall and pneumatosis cystoides intestinalis (PCI)in the wall of the small intestine. Because there was no sign of peritoneal irritation, we decided to use conservative therapy. Neither HPVG nor PCI was observed on the abdominal CT scan taken 14 days after the onset of failure.Oral intake was started and the patient took a 1400-kilocalorie diet daily.The levels of serum alanine aminotransferase (ALT),aspartate aminotransferase (AST)and lactate dehydrogenase (LDH)were increased on the 40th day after the onset of failure.On the 46th day,respiratory and cardiac arrest occurred.His blood sugar level was below 20mg/dl. Intravenous hyperalimentation was started. Hypoglycemia was not present from the next day. The cause of the hypoglycemia was supposed to be malabsorption and liver insufficiency, which might have been caused by HPVG and PCI. It is supposed that patients with HPVG and PCI with malnutrition need careful observation for a long period after recovery from HPVG and PCI. Shinshu Med J 59 : 265― 271, 2011
Article
信州医学雑誌 59(4): 265-271(2011)
信州医学会
2011-08-10
jpn
departmental bulletin paper
VoR
http://hdl.handle.net/10091/13224
https://soar-ir.repo.nii.ac.jp/records/4156
https://doi.org/10.11441/shinshumedj.59.265
10.11441/shinshumedj.59.265
0037-3826
AN00120815
信州医学雑誌
59
4
265
271
https://soar-ir.repo.nii.ac.jp/record/4156/files/Shinshu_med59-4-07.pdf
application/pdf
445.6 kB
2015-09-24