RESUMO
Acute gastric dilatation is a rare cause of gas within the hepatic portal vein, but one that is important to recognise as prompt decompression via a nasogastric tube is usually successful in resolving the situation. We report the rare case of a 68-year-old man with spontaneous acute gastric dilatation 50 minutes after a dobutamine stress echo that resulted in pneumoporta. The patient had a Nissen's fundoplication 18 months previously; patients with previous antireflux surgery or who have a degree of gastric outlet obstruction may be at increased risk of this unusual condition. Conservative management, with placement of a nasogastric tube was successful in resolving his symptoms.
Assuntos
Agonistas de Receptores Adrenérgicos beta 1/efeitos adversos , Dobutamina/efeitos adversos , Ecocardiografia sob Estresse/efeitos adversos , Embolia Aérea/etiologia , Dilatação Gástrica/etiologia , Veia Porta , Agonistas de Receptores Adrenérgicos beta 1/uso terapêutico , Idoso , Dobutamina/uso terapêutico , Ecocardiografia sob Estresse/métodos , Fundoplicatura/efeitos adversos , Humanos , MasculinoRESUMO
Better understanding of the dual functionality of the spleen has led to a conservative approach to splenic trauma. With accurate assessment and vigilant clinical examination up to two thirds of splenic injuries can be managed expectantly; when surgery is unavoidable, splenic preserving techniques may be used to maintain function.