每日一题_2025.05.17

A 68-year-old man with cirrhosis presented to the emergency department with a 2-day history of severe abdominal pain. On physical examination, hypoactive bowel sounds, pain with palpation, and rebound tenderness throughout the abdomen were noted. Computed tomography of the abdomen with administration of contrast material showed thrombosis of the superior mesenteric vein (left, arrows). What complication of superior mesenteric vein thrombosis was also seen on imaging?

一名患有肝硬化的68岁男性因严重腹痛2天前往急诊科就诊。体格检查发现肠鸣音减弱、触诊疼痛以及全腹反跳痛。腹部增强计算机断层扫描显示肠系膜上静脉血栓形成（左图，箭头所示）。影像学检查还发现了肠系膜上静脉血栓形成的哪种并发症？

A. Ascites腹水

B. Ischemic Colitis缺血性结肠炎

C. Portal hypertension 门静脉高压

D. Small-Bowel Perforation小肠穿孔

E. Small-Bowel Infarction小肠梗死

答案解析：

正确答案是由急性肠系膜上静脉血栓形成继发的小肠梗死。对于该患者，腹部右下象限有一段较长的小肠肠壁增厚且强化程度降低（中间，星号所示）。剖腹探查发现从远端空肠至近端回肠的肠管呈暗紫色（右侧）。随后进行了梗死小肠切除术、经静脉溶栓及取栓术，并实施了肠吻合术。

正确答案：E