Hepatic portal venous gas: clinical significance of computed tomography findings

Hou, Sen; Chern, Chorng–Shyan; How, Chorng–Kuang; Chen, Jen Dar; Wang, Lee Min; Lee, Chen Hsen

doi:10.1016/j.ajem.2004.02.017

Cited by 107 publications

(84 citation statements)

References 17 publications

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“…We review the literature to clarify the clinical relevance of this combination and emphasize the importance of performing early laparotomy in patients with acute bowel ischemia. [11][12][13][14][15][16] Case Report…”

Section: Introductionmentioning

confidence: 99%

Portomesenteric venous gas in acute bowel ischemia: Report of a case

2008

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Portomesenteric venous gas and pneumatosis intestinalis (PI) are rare but important radiographic findings. They are usually discussed separately in the literature and little is known about the clinical importance of their combination in acute bowel ischemia. Abdominal computed tomography (CT) has proven useful for detecting subtle portomesenteric venous gas or PI in the early stages of acute bowel ischemia. Although the CT findings of either portomesenteric venous gas or PI as separate entities are not pathognomonic of bowel infarction, CT evidence of the combination of both these disorders is strongly associated with transmural bowel infarction, especially band-like pneumatosis. We report a case of portomesenteric venous gas combined with band-like pneumatosis, diagnosed based on CT evidence of both findings. We performed an emergency laparotomy for suspected acute bowel ischemia, which was confirmed by the operative findings.

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Section: Introductionmentioning

confidence: 99%

Portomesenteric venous gas in acute bowel ischemia: Report of a case

2008

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“…[6,11,12]. For patients without peritonitis mortality approaches 20-30% conservative management works well but clinicians are advised to have a low threshold for surgery and close monitoring of the patient [4,[13][14]. However, there is limited data to determine the best treatment choice.…”

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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“…8 However, in some cases, the pathogenesis for the appearance could not be well defined. 9 Today, increased utilization of advanced radiographic methods in emergency situations has led to increased detection of HPVG associated with various benign non-ischemic conditions that do not necessarily require surgery. 5 HPVG has been reported in many non fatal conditions, such as bowel necrosis (72%), ulcerative colitis (8%), intra-abdominal abscesses (6%), small bowel obstruction (3%) and gastric ulcers (3%) since it was first described.…”

Section: Discussionmentioning

confidence: 99%

Portal Venous Gas Resulting from Enteritis in a Case with Portal Hypertension: Case Report

Yılmaz¹,

Koruk²,

Önbaş³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T Hepatic portal venous gas is an uncommon radiographic finding. The mechanism for the appearance of gas in the portal vein is unknown. The most important predisposing factor is the damage to the intestinal mucosa combined with bowel distension or bacterial gas production. Our case presented with abdominal pain, fever, diarrhea and abdominal distension. We diagnosed portal vein thrombosis in computed tomography and saw gas image in the portal vein. It is important to know the underlying pathology for decision making on portal vein gas occurrence. If there is no intestinal ischemic injury requiring surgery, conservative follow up may be the therapeutic option.

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Hepatic portal venous gas: clinical significance of computed tomography findings

Cited by 107 publications

References 17 publications

Portomesenteric venous gas in acute bowel ischemia: Report of a case

Portomesenteric venous gas in acute bowel ischemia: Report of a case

Necrotizing pancreatitis presenting with hepatic portal venous gas and pneumatosis intestinalis

Portal Venous Gas Resulting from Enteritis in a Case with Portal Hypertension: Case Report

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