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Hepatic portal venous gas is an entity frequently associated with a sinister outcome in infantile necrotizing enterocolitis, small bowel infarction and intra-abdominal sepsis (Sisley et al, 1987). A recent case report described its occurrence in a patient receiving monoclonal antibody therapy (Waymack et al, 1987). We describe a case in which portal venous gas appeared secondary to therapeutic embolization of the hepatic artery, a phenomenon which, to our knowledge, has not been reported previously. The diagnosis was made by computed tomography (CT) and the gas remained in the portal system for at least 8 days. A 22-year-old male patient was referred from another hospital following a road traffic accident 2 weeks previously. Laparotomy immediately after the accident had revealed two deep lacerations in the right lobe of liver which were controlled by suturing and drainage. Post-operatively the patient had a persistent pyrexia followed 2 weeks later by melaena and haematemesis associated with hypotension and right hypochondrial pain.

Vapreotide appears to have benefit in the control of acute variceal bleeding. It is easy to administer and has few side effects, which are minor. These findings endorse the need for future trials to evaluate vapreotide and its use in acute variceal hemorrhage, a morbidity among patients with cirrhosis.

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