scholarly journals Hepatic Portal Venous Gas: Comparison of Two Cases

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Iain Rankin ◽  
Hemant Sheth
Keyword(s):  
Surgical Intervention ◽  
Clinical Course ◽  
Mortality Rates ◽  
Watch And Wait ◽  
Hepatic Portal Venous Gas ◽  
Bowel Ischaemia ◽  
Portal Venous Gas ◽  
Low Threshold ◽  
Hepatic Portal ◽  
Gastric Ischaemia

Context.Hepatic portal venous gas (HPVG) is a rare and sinister finding. Its mortality is associated with the underlying causative condition. When secondary to bowel ischaemia, mortality rates exceed 50%.Case Report.Two cases of HPVG are described. One case describes HPVG in association with gastric ischaemia, with complete resolution following conservative management. The second case describes HPVG in association with widespread intra-abdominal ischaemia, with resultant mortality.Conclusion.A “watch and wait” management of HPVG associated with gastric ischaemia is suggested in certain patients, with a low threshold for surgical intervention. HPVG associated with bowel ischaemia is an absolute indication for surgical intervention, where intervention may change the clinical course.

Acidosis and Hepatic Portal Venous Gas: Indications for Surgery in Necrotizing Enterocolitis

PEDIATRICS ◽  
1986 ◽  
Vol 78 (2) ◽  
pp. 273-277 ◽  
Author(s):  
Robert Buras ◽  
Philip Guzzetta ◽  
Gordon Avery ◽  
Cheryl Naulty
Keyword(s):  
Necrotizing Enterocolitis ◽  
Surgical Intervention ◽  
Medical Center ◽  
Study Group ◽  
Indications For Surgery ◽  
Hepatic Portal Venous Gas ◽  
Portal Venous Gas ◽  
The Past ◽  
National Medical ◽  
Hepatic Portal

A retrospective review of cases of necrotizing enterocolitis seen at the Children's Hospital National Medical Center during the past 5 years was performed to identify factors that indicate a need for surgical intervention. The study group consisted of 92 neonates. Persistent acidosis and hepatoportal venous gas were significantly more common in babies requiring surgery than in those who were managed medically. Other physical, radiologic, and laboratory factors did not occur more frequently in those children going to surgery. Neonates with hepatoportal venous gas or persistent acidosis should be treated aggressively, and surgical intervention should be considered early in this group. Such an approach may serve to reduce morbidity and mortality in the future.

Colo Venous Fistula: A Rare Cause of Hepatic Portal Venous Gas

2020 ◽  
Vol 1 (2) ◽  
pp. 67-69
Author(s):  
Nazmi Özer ◽  
Hüseyin Kılavuz ◽  
Ahmet Şeker ◽  
Abdullah Şahin ◽  
Sinan Sözütok
Keyword(s):  
Mortality Rates ◽  
Portal System ◽  
Sigmoid Diverticulitis ◽  
Hepatic Portal Venous Gas ◽  
Colon Wall ◽  
Portal Venous Gas ◽  
Hepatic Portal ◽  
Venous Fistula

Hepatic portal venous gas (HPVG) is a rare clinical picture with high mortality. It is characterized by the accumulation of gas in the portal system on radiological examination. We presented a 74-year-old male patient who was followed up due to sigmoid diverticulitis, developed progressive colo venous fistula and HPVG during the follow-up and resulted in death. Diverticulitis is mainly associated with sigmoid diverticulosis. The anti-biotherapy is preferred if there is any contamination in the surrounding adipose tissue or an abscess formed adjacent to the colon wall. However, surgery is required if there is no regression in the follow-up. Colovenous fistula is rarely seen in the etiology of HPVG, but it is among the diagnoses to be kept in mind. The quick diagnosis of disease, the determination of its etiology and the choice of surgical treatment, and the post-operative intervention will decrease the mortality rates associated with the disease.

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

2018 ◽  
pp. bcr-2018-226594 ◽  
Author(s):  
Faisal Inayat ◽  
Fahad Zafar ◽  
Muhammad Adnan Zaman ◽  
Qulsoom Hussain
Keyword(s):  
Surgical Intervention ◽  
Radiographic Finding ◽  
Hepatic Portal Venous Gas ◽  
Diagnostic Modality ◽  
Portal Venous Gas ◽  
Comparative Review ◽  
The Mean ◽  
Gastric Emphysema ◽  
Hepatic Portal ◽  
Benign Course

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.

scholarly journals Hepatic portal venous gas with associated bowel ischaemia and intra-abdominal sepsis after recent chemotherapy

2016 ◽  
pp. bcr2015213564
Author(s):  
Alexander Marcus Dashwood ◽  
Robert Mason ◽  
Courtney Jennings ◽  
Priyanka Dhillon
Keyword(s):  
Abdominal Sepsis ◽  
Hepatic Portal Venous Gas ◽  
Bowel Ischaemia ◽  
Portal Venous Gas ◽  
Hepatic Portal

scholarly journals Non-surgical treatment of gastric emphysema with intraabdominal free gas and hepatic portal venous gas: Lessons from a rare case

2020 ◽  
Vol 8 ◽  
pp. 2050313X2094594
Author(s):  
Tadashi Furihata ◽  
Takafumi Ushiku ◽  
Isao Murayama ◽  
Jun Sato ◽  
Tomohisa Kamo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Intervention ◽  
Hepatic Portal Venous Gas ◽  
Free Gas ◽  
Portal Venous Gas ◽  
Gastric Decompression ◽  
General Surgeons ◽  
Abdominal Examination ◽  
Gastric Emphysema ◽  
Hepatic Portal

We herein describe a case of an 83-year-old man who presented with epigastralgia, vomiting, and abdominal distention. The physical abdominal examination revealed mild tenderness. Computed tomography revealed intramural gastric gas spread throughout the stomach, intraabdominal free gas, and hepatic portal venous gas. We diagnosed gastric emphysema with intraabdominal free gas and hepatic portal venous gas. We selected a wait-and-watch approach because physical examination did not show any peritoneal signs, although the radiological examinations showed remarkable findings. As a result, he received conservative therapy with fasting, intravenous infusion of antibiotics, and gastric decompression by nasogastric intubation. The patient was relieved of the symptoms, and follow-up computed tomography showed that all the abnormal gas disappeared soon after the treatment. In conclusion, the intramural gastric gas even with both intraabdominal free gas and hepatic portal venous gas does not always require surgical intervention. In case clinicians including general surgeons and physicians encounter intraabdominal free gas with hepatic portal venous gas, gastric emphysema should be considered in the different diagnosis. Lack of knowledge may lead to misdiagnosis, which may result in unnecessary surgical intervention.

scholarly journals Hepatic Portal Venous Gas: An Ill Omen or a Misleading Sign

2020 ◽  
Vol 06 (01) ◽  
pp. e37-e41
Author(s):  
Shruti Mehta ◽  
Gunjan S. Desai ◽  
Saumil Shah ◽  
Hitesh Mehta ◽  
Aniruddha Phadke
Keyword(s):  
Clinical Judgment ◽  
Tumor Lysis Syndrome ◽  
Radiological Finding ◽  
Young Male ◽  
Mortality Rates ◽  
Lymphocytic Leukemia ◽  
Hepatic Portal Venous Gas ◽  
Portal Venous Gas ◽  
Bowel Gangrene ◽  
Hepatic Portal

AbstractHepatic portal venous gas (HPVG), a rare radiological finding, is historically considered an ominous sign with 100% mortality rates. The dictum that HPVG warrants surgical intervention is challenged in the recent literature. This is because of the identification of various causes of HVPG other than bowel gangrene. Most of these newly identified causes can be managed conservatively. However, bowel gangrene, if missed, is fatal. Hence, sound clinical judgment and accurate diagnosis based on specific clinical parameters and imaging findings are important. We present a case of a young male with tumor lysis syndrome and neutropenic sepsis. He underwent treatment for a relapse of T-cell acute lymphocytic leukemia and presented with abdominal pain and distension. Computed tomography (CT) scan showed HPVG, and the differential diagnosis was neutropenic colitis or pseudomembranous colitis, with steroid use as the probable cause. The patient was managed conservatively. The case emphasizes that the evaluation for a specific cause of HPVG is important to reduce unnecessary surgery. A succinct literature review provides the reasons for the changing mortality rates.

scholarly journals Factors associated with indications for surgery and the presence of intestinal necrosis in patients with hepatic portal venous gas: A multicenter retrospective cohort study

2020 ◽  
Author(s):  
Ryohei Matsui ◽  
Satoru Takayama ◽  
Akifumi Kawate ◽  
Kohei Takura ◽  
Taku Hattori ◽  
...  
Keyword(s):  
Cohort Study ◽  
Surgical Intervention ◽  
Laboratory Data ◽  
Hepatic Portal Venous Gas ◽  
Intestinal Necrosis ◽  
Factors Associated ◽  
Portal Venous Gas ◽  
Ct Findings ◽  
Significant Difference ◽  
Hepatic Portal

Abstract Background The presence of hepatic portal venous gas (HPVG) has been associated with intestinal necrosis and is an indication for surgical intervention. But some cases can be treated conservatively. This study aimed to examine the factors associated with the need for surgical intervention and the development of intestinal necrosis in patients with HPVG.Methods This was a retrospective, multicenter and observational cohort study consisting of 166 patients who were diagnosed as having HPVG based on CT findings between April 2013 and March 2019. The patients were divided into two groups: surgery Required Group and Non-surgery Required Group. We reviewed medical records for clinical backgrounds, vital signs, laboratory data, CT findings, and compared the two groups using the Chi-square test and Student’s t-test with p-values < 0.05 indicating statistical significance.Results There were 72 patients in the Surgery Required Group and 94 in the Non-surgery Required Group. There were no statistically significant differences in age and sex between the two groups. Pulse rate (PR) ( p = 0.004), C-reactive protein (CRP) ( p = 0.012), lactate dehydrogenase (LDH) ( p = 0.006) and abnormality of the white blood cell count (WBC) ( p = 0.012) in the Surgery Required Group were significantly higher than those in the Non-surgery Required Group. The diameter of the superior mesenteric artery (SMA) and vein (SMV), and ratio of SMV/SMA were measured but no statistically significant difference was observed. Band-like pneumatosis ( p < 0.001) and ring like pneumatosis( p < 0.001) were observed with a significantly higher frequency in the Surgery Required Group, but no significant difference was observed in bubble-like pneumatosis. Intrahepatic HPVG was significantly more frequent in the Non-surgery Required Group than surgery Required Group ( p < 0.001), and extrahepatic HPVG ( p < 0.001) was the opposite result. There was no significant difference of HPVG distribution in lobes.Conclusions PR, CRP, LDH, abnormality of WBC, band-like pneumatosis, ring-like pneumatosis, and extrahepatic HPVG are the factors associated with an indication for surgery indication and intestinal necrosis in patients with HPVG.

Hepatic portal venous gas

2005 ◽  
Vol 189 (4) ◽  
pp. 501-503 ◽  
Author(s):  
Hsin-Hui Chiu ◽  
Chan-Ming Chen ◽  
Yen-Yuan Lu ◽  
Jackson Ching-Tzer Lin ◽  
Lein-Ray Mo
Keyword(s):  
Hepatic Portal Venous Gas ◽  
Portal Venous Gas ◽  
Hepatic Portal
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