Conservative management of gastric emphysema with hepatoportal venous gas

Tang, Ceen-Ming; Yarandi, Shadi S.; Laxton, William; Khashab, Mouen A.

doi:10.1136/bcr-2015-211669

Cited by 6 publications

(6 citation statements)

References 2 publications

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“…In contrast, a hypodense lineal or curve fringe on the stomach wall arises in GE, with no evidence of gastric wall thickening. Concomitant HPVG may also be detected in both conditions, as the left gastroepiploic veins are part of the portal venous system [15].…”

Section: Discussionmentioning

confidence: 99%

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Gastric Emphysema and Hepatic Portal Vein Gas as Complications of Noninvasive Positive Pressure Ventilation

Alataby

Daniel

Bibawy

et al. 2020

Cureus

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Gastric emphysema (GE) in association with hepatic portal vein gas (HPVG) is a rare, benign medical condition that is very seldom caused by noninvasive positive pressure ventilation (NIPPV). This report describes a patient who developed GE along with gastric vein gas and HPVG, most likely due to multiple episodes of vomiting in combination of using bilevel positive airway pressure (BiPAP), a form of NIPPV. The patient responded to conservative treatment with intravenous fluids, pantoprazole, and the urgent cessation of BiPAP and oral intake.

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Section: Discussionmentioning

confidence: 99%

“…Conservative treatment without surgical intervention has been found to be successful in the management of most of these cases. Nevertheless, urgent exploratory surgery may be needed if there is a high suspicion of a necrotic or ischemic etiology [7,[14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Gastric Emphysema and Hepatic Portal Vein Gas as Complications of Noninvasive Positive Pressure Ventilation

Alataby

Daniel

Bibawy

et al. 2020

Cureus

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“…In patients with a stable haemodynamic status, conservative treatment using bowel rest, gastric decompression, intravenous fluids, antiemetics, antibiotics and proton-pump inhibitors is usually sufficient 11. However, if patients are haemodynamically unstable and signs of acute abdomen are present, then immediate surgical exploration is warranted.…”

Section: Discussionmentioning

confidence: 99%

Gastric emphysema secondary to severe vomiting: a comparative review of 14 cases

Inayat¹,

Zafar

Zaman

et al. 2018

BMJ Case Reports

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Gastric emphysema is characterised by the presence of air within the wall of the stomach. The radiographic finding of gastric emphysema with hepatic portal venous gas is classically an ominous sign, associated with a high mortality rate. We report one case from our clinical experience and undertake a review of the previously reported cases of vomiting-induced gastric emphysema retrieved from the PubMed. A total of 14 cases were found to date. The mean age at the time of diagnosis was 45.6 years (range, 9 months to 81 years). Computed tomography abdomen was the frequently used diagnostic modality. Interestingly, conservative treatment led to a clinical cure and resolution of gastric emphysema as well as the associated hepatic portal venous gas in most of the patients. This review illustrates that vomiting-related gastric emphysema entails a more benign course and surgical intervention can be avoided with a prompt aetiology establishment in these patients.

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“…Alternatively, pneumatosis intestinalis with hepatic portal venous gas is a high-risk factor for bowel ischaemia, which has a high mortality. Although some cases have been resolved by conservative management,3 clinicians should not underestimate the need for surgical consultation.…”

Section: Descriptionmentioning

confidence: 99%