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

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.