A case of portal venous gas caused by the use of a nasojejunal nutrition tube.

Abstract

We reported a case of portal vein pneumatosis caused by a nasojejunal nutrition tube that was successfully treated conservatively. This patient was discharged after 1 week of treatment with imipenem/cilastatin sodium for anti-infection, gastrointestinal decompression, fluid replacement, and pain relief, and the patient's abdominal pain was significantly relieved. The main pathogenesis of hepatic portal venous gas is as follows: (a) increased pressure in the digestive tract leading to gas entering the portal vein circulation through the intestinal wall and finally into the liver; (b) destruction of the intestinal mucosa causing the gas formed by intestinal bacteria to enter the portal vein system; and (c) diffusion of gas produced by bacteria in intraperitoneal abscesses or portal vein and mesentery, causing pyelitis. The successful treatment of this patient highlights that addressing physical factors, providing gastrointestinal decompression, and administering anti-infection therapy can aid in the management of such cases. Bacterial culture of gastric juice and drug sensitivity testing can guide effective anti-infection treatment.