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Original Article
 
Non-inflammatory or non-ischemic vascular gas on emergent multi-detector computed tomography: Eight years' experience
Kazuya Sugimori1, Izumi Torimoto1, Kyota Nakamura1, Masaaki Kondo1, Kazushi Numata1, Shigeo Takebayashi1
1From the Gastroenterology Center (KS, MK, KN), the Department of Diagnostic Radiology (IT, ST) and, the Critical Care and Emergency Center (KN), Yokohama City University Medical Center.

Article ID: 100004R02KS2016
doi:10.5348/R02-2016-4-OA-2

Address correspondence to:
Izumi Torimoto
Department of Diagnostic Radiology, Yokohama City University Medical Center
4-57, Urafune-cho, Minami-ku
Yokohama, 232-0024
Japan

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How to cite this article
Sugimori K, Torimoto I, Nakamura K, Kondo M, Numata K, Takebayashi S. Non-inflammatory or non-ischemic vascular gas on emergent multi-detector computed tomography: Eight years' experience. Edorium J Radiol 2016;2:12–19.


Abstract
The study aimed to characterize the etiology and clinical significance of non-inflammatory or non-ischemic vascular gas on multi-detector computed tomography (MDCT). We reviewed MDCT images and clinical charts of patients with vascular gas excluding inflammatory or ischemic entities in our hospital between 2008 and 2015. The local cases and the case report papers, which were extracted from English literature in PubMed were summarized according to iatrogenic or non-iatrogenic causes to analyze etiology for the entry of air into the circulation.Our local series demonstrated single or multiple collection of vascular gas in 15 patients including one with systemic arterial gas; the most frequent was cerebral vascular gas (CVG, n = 11, 0.8–12 mL) followed by hepatic vascular gas (n = 10, 0.4–256 mL). The accumulative 144 cases including the 15 local cases included 62 (43.1%) with iatrogenic vascular gas; the most frequent was central venous catheter-related CVG (48 cases) with 39.5% mortality followed by hepatic portal venous gas (20 cases) with 15% mortality. A careful search for clues on MDCT images was useful in discussing the etiology of vascular gas entry points and increased awareness of the emergent clinical settings where the vascular gas occurred.

Keywords: Brain, Iatrogenic complication, Portal vein, Vascular gas


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Author Contributions:
Kazuya Sugimori – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Izumi Torimoto – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kyota Nakamura – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Masaaki Kondo – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kazushi Numata – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Shigeo Takebayashi – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Kazuya Sugimori et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.