Clinical Evaluation of Hepatic Portal Venous Gas after Abdominal Surgery

Abstract

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.

Conservative approach to Hepatic Portal Venous Gas: A case report

“…Case reports of on HPVG associated to benign etiologies have been increasing since 1980 with the increased use of more sensitive diagnostic imaging techniques (ultrasonography and CT). The high mortality rate lead to consider HPVG an indication of mandatory explorative laparotomy throughout the last fifty years [8], [9], [11]. The latter increase incidence of benign conditions HPVG correlated suggest to change the common invasive therapeutic approach to lesser invasive treatment [10].…”

“…There is a scant literature on HPVG induced by postoperative complication after surgery. Although is a severe and life threatening condition, early detection and sistemic treatment lead to a better patient outcome as in our experience [6], [7], [8], [9], [10], [11].…”

An Update on Eosinophilic Esophagitis: Etiological Factors, Coexisting Diseases, and Complications

“…It is often related to significant underlying pathologies such as intestinal ischemia, sepsis, inflammatory bowel diseases, bowel obstruction, diverticulitis, appendicitis, and trauma. Rarely, hepatic portal venous gas after an upper gastrointestinal endoscopy and dilation for benign esophageal strictures with EoE has also been reported in few studies [124, 125].…”

Hepatic Portal Venous Gas and Anastomotic Leakage

“…Furthermore, in our literature review, we reported a paper that presented a case of HPVG with anastomosis leakage [3]. Other papers we reported presented cases of HPVG due to surgical complications, while not specifying which types [4][5][6][7]. We write this letter to specify that the HPVG condition could be associated with anastomotic leakage and the management of this surgical complication should also solve the portal venous gas problem.…”

“…In our case, “a computed tomography scan showed little perianastomotic collections with air-fluid levels and massive hepatic portal venous gas.” Furthermore, in our literature review, we reported a paper that presented a case of HPVG with anastomosis leakage [ 3 ]. Other papers we reported presented cases of HPVG due to surgical complications, while not specifying which types [ 4 - 7 ].…”