Hepatic portal venous gas: A case report and review of literature

Kesarwani, Vikas; Ghelani, Dhaval; Reece, Graham

doi:10.4103/0972-5229.56058

Cited by 21 publications

(28 citation statements)

References 13 publications

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“…A mechanical theory due to ischaemic bowel damage and a bacterial theory due to gas-forming organisms have been explained to be the two causes of HPVG 6 7. In this case, it was felt that gas-forming enteritis led to portal sepsis causing air within the hepatic portal venous system and the pneumatosis intestinalis.…”

Section: Discussionmentioning

confidence: 91%

Case of pneumatosis intestinalis and hepatic portal venous gas following a laparoscopic right hemicolectomy

Castren¹,

Hakeem

Mahmood

et al. 2016

BMJ Case Reports

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Hepatic portal venous gas (HPVG) in most cases signifies either mechanical migration of air into the portal system due to bowel ischaemia (pneumatosis intestinalis) or portal sepsis due to gas-forming organisms. Successful management of portal sepsis involves early identification of the condition, intensive resuscitation, broad-spectrum antibiotics and a laparotomy for possible bowel ischaemia. In this report, we discuss the case of a patient with pneumatosis intestinalis and HPVG after an elective laparoscopic right hemicolectomy. After an initial slow recovery, on postoperative day seven, the patient had profuse diarrhoea and confusion, and was hyponatraemic. A CT scan revealed pneumatosis intestinalis and HPVG. A laparotomy showed no obvious cause for HPVG and there was no ischaemic bowel. She was managed with intensive care, hyperbaric oxygen therapy, broad-spectrum antibiotics and total-parenteral nutrition. She has made a good recovery. This case highlights the presenting features, differential diagnoses, and management of pneumatosis intestinalis and HPVG.

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Section: Discussionmentioning

confidence: 91%

Case of pneumatosis intestinalis and hepatic portal venous gas following a laparoscopic right hemicolectomy

Castren¹,

Hakeem

Mahmood

et al. 2016

BMJ Case Reports

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“…In HPVG, air will extend within 2 cm of the liver capsule. Gas will move peripherally due to centrifugal flow of blood 5. In pneumobilia, air in the biliary tract remains central tothe portal hilum and does not extend to within 2 cm of the liver capsule 5.…”

Section: Discussionmentioning

confidence: 99%

“…Gas will move peripherally due to centrifugal flow of blood 5. In pneumobilia, air in the biliary tract remains central tothe portal hilum and does not extend to within 2 cm of the liver capsule 5. Gas moves in the biliary tree toward the porta hepatis because of the centripetal force of bile.…”

Section: Discussionmentioning

confidence: 99%

A Fatal Case of Hepatic Portal Venous Gas Associated With Hemodialysis

Begum

Ahmed

2016

ACG Case Reports Journal

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“…Ischaemic bowel is the primary aetiology in 70% of HPVG cases, with 91% relating to transmural necrosis. Mortality rate is 75–90%, which only increases when associated with pneumatosis intestinalis 1. The proposed mechanism for gas formation is not well understood but is thought to involve gas-forming organisms crossing the intestinal lumen, into the mesenteric veins, and accumulating in the portal venous system and hepatic parenchyma 2.…”

Section: Descriptionmentioning

confidence: 99%