Acute Gastric Dilatation: A Transient Cause of Hepatic Portal Venous Gas—Case Report and Review of the Literature

Allaparthi, Satya; Anand, Curuchi

doi:10.1155/2013/723160

Cited by 18 publications

(15 citation statements)

References 26 publications

(34 reference statements)

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“…Although the presence of gas in the portal venous system was generally considered to be a serious intra-abdominal event, many benign cases have been put forward with the development of imaging modalities. Our search for reported cases of HPVG during the most recent 5 years (table 2 ) [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] revealed that 20 of the 31 patients were treated by a nonsurgical approach, and 22 (71%) of the 31 patients recovered, suggesting that HPVG is not always a fatal sign in those patients. In addition, invasive therapy, including chemotherapy, endoscopic retrograde cholangiopancreatography, and CT-guided aspiration biopsy, was performed in 14 (45.2%) of the 31 patients before onset of HPVG.…”

Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Hepatic Portal Venous Gas after Abdominal Surgery

Okada

Azuma

Kawashita

et al. 2016

Case Rep Gastroenterol

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Hepatic portal venous gas (HPVG) is induced by various abdominal diseases. Since HPVG is accompanied by bowel ischemia, intestinal infection and hypovolemia, various modes of critical management are needed to treat the underlying conditions. HPVG associated with abdominal complications after surgery has rarely been reported. We present 4 patients with HPVG after abdominal surgery: 2 of the 4 patients died of multiple organ failure, and the other 2 recovered with solely conservative therapy. Although postoperative HPVG is a severe and life-threatening condition, early detection and systemic treatment lead to a better patient outcome.

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Section: Discussionmentioning

confidence: 99%

Clinical Evaluation of Hepatic Portal Venous Gas after Abdominal Surgery

Okada

Azuma

Kawashita

et al. 2016

Case Rep Gastroenterol

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“…Hepatic portal venous gas (HPVG) was described more than 55 years ago and is commonly associated with intramural bowel gas called pneumatosis intestinalis [1]. The frequency of detection of HPVG and pneumatosis intestinalis appears to be increasing.…”

Section: Discussionmentioning

confidence: 99%

“…[2,4]. The overall mortality rate can be as high as 75-90%, depending on the underlying etiology [1,5]. In last decades, mortality rate seems to be lower, and is considered to be the result of early diagnosis as well as its association with unimportant causes, in which conservative management is more beneficial [6].…”

Section: Discussionmentioning

confidence: 99%

Necrotizing pancreatitis presenting with hepatic portal venous gas and pneumatosis intestinalis

Salazar¹,

Escoto²,

Salazar³

2014

Int J Hepatobiliary Pancreat Dis

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A 68-year-old male with past medical history of diabetes mellitus and two previous episodes of mild acute pancreatitis was admitted to the hospital with a 12-hour history of severe epigastric pain and nausea. He reported no recent alcohol consumption, and current medication was metformin. On initial physical examination, he had a temperature of 38.5°C, a heart rate of 94 beats per minute, and a respiratory rate of 26 breaths per minute. The patient had moderate epigastric abdominal tenderness without peritoneal irritation. Laboratory examination revealed white blood cell count 16,100/mm 3 , hematocrit 46.40%, glucose 26.9 mmol/L, serum amylase 1564 U/L, serum lipase 4116 U/L, serum alanine aminotransferase 380 U/L, serum lactate dehydrogenase 421 U/ L, alkaline phosphatase 248 U/L, direct bilirubin 3.0 mg/dL, BUN 12 mg/dL. Calcium, triglyceride, and electrolyte values were normal. Electrocardiography (ECG) and chest X-ray were normal. He was treated with intravenous fluids and pain relief medication. Several hours after admission the patient deteriorated, became hypotensive and dyspneic with increasing epigastric pain and peritoneal irritation, and required mechanical ventilation. Contrast-enhanced computed tomography of abdomen revealed gas in the portal vein, gastric pneumatosis, necrosis of the pancreas and pneumatosis intestinalis (Panels A and B).

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“…HPVG is generally considered an alarming radiological sign as it is associated with high mortality in all age groups [1,2]. The most common recognized life threatening conditions leading to portal venous gas include ischemic necrotic bowel, necrotizing enterocolitis, intra-abdominal abscess, inflammatory bowel disease, acute hemorrhagic pancreatitis, gastric ulcer and diabetic ketoacidosis [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Infantile Hypertrophic Pyloric Stenosis - A Rare Cause of Hepatoportal Venous Gas

Usman¹

2014

Pediat Therapeut

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Hepatic portal venous gas (HPVG) is usually associated with necrotizing enterocolitis or bowel ischemia in infants but it's a rare finding with hypertrophic pyloric stenosis (HPS). In such cases, portal venous gas is a benign incidental finding and does not advocate any delay in the surgical treatment. We report this atypical case of 3 weeks old male infant with HPS having portal venous gas that was detected on abdominal ultrasound. Our patient with a history of term delivery was brought to the pediatric department of Combined Military Hospital Lahore on 25th of November, 2013 with complaints of vomiting and constipation for the last 4 days. Physical examination showed that the infant was lethargic and mildly dehydrated with soft and non-tender abdomen. Baseline blood tests revealed metabolic alkalosis with hemoglobin and total leukocyte count within normal limits. Plain xray abdomen showed a distended stomach with no signs of gut obstruction. Abdominal ultrasonography revealed a severely thickened and lengthened pylorus suggestive of hypertrophic pyloric stenosis. Moreover, ultrasound also showed multiple echogenic foci diffusely involving the both lobes of otherwise normal sized liver. Moving air bubbles were also detected in the extra and intra hepatic portal and splenic veins on dynamic scanning confirming the presence of portal venous gas. The infant underwent Ramstedt's pyloromyotomy for HPS. The infant showed a steady recovery and ultrasonography performed at 2nd post op day detected no signs of gas within the hepato portal veins.

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Acute Gastric Dilatation: A Transient Cause of Hepatic Portal Venous Gas—Case Report and Review of the Literature

Cited by 18 publications

References 26 publications

Clinical Evaluation of Hepatic Portal Venous Gas after Abdominal Surgery

Clinical Evaluation of Hepatic Portal Venous Gas after Abdominal Surgery

Necrotizing pancreatitis presenting with hepatic portal venous gas and pneumatosis intestinalis

Infantile Hypertrophic Pyloric Stenosis - A Rare Cause of Hepatoportal Venous Gas

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