Hepatic Portal Venous Gas: An Unusual Complication Following Upper Endoscopy and Dilation

A 57-year-old female with intrahepatic cholangiocarcinoma underwent hepatic trisegmentectomy and chemoradiation. Her course was complicated by recurrent episodes of radiation-induced gastric outlet obstruction requiring balloon dilations. She presented with right lower quadrant pain after routine upper endoscopy with pyloric dilation. A computed tomography (CT) showed isolated right-sided ischemic colitis with vascular contrast in the mesentery. Repeat CT after conservative management revealed near resolution of the ischemic changes. Perforation at the level of the pylorus is a complication of endoscopic pyloric dilation but vascular injury has never been described.

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“…A recent case of portal venous gas post-endoscopic esophageal dilation adds to the evidence that vascular injuries can occur. 6 …”

Section: Discussionmentioning

confidence: 99%

“… 5 To date, no arterial injuries have been reported following endoscopic dilation, though a recent report of hepatic portal venous gas following endoscopic dilation suggests that this might be a newly recognized, rare complication. 6 …”

Section: Introductionmentioning

confidence: 99%

Vascular Injury Following Pyloric Dilation: Unusual Cause of Ischemic Colitis

Riff

Aarons

Metz

2014

ACG Case Reports Journal

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“…It is often related to significant underlying pathologies such as intestinal ischemia, sepsis, inflammatory bowel diseases, bowel obstruction, diverticulitis, appendicitis, and trauma. Rarely, hepatic portal venous gas after an upper gastrointestinal endoscopy and dilation for benign esophageal strictures with EoE has also been reported in few studies [124, 125].…”

Section: Complicationsmentioning

confidence: 99%

An Update on Eosinophilic Esophagitis: Etiological Factors, Coexisting Diseases, and Complications

Khan

Guo

et al. 2020

Digestion

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Background: Eosinophilic esophagitis (EoE) is an immune-mediated clinicopathological condition characterized by esophageal infiltration with eosinophils resulting in chronic inflammation and stricture. Summary: The recent increase in the incidence of EoE and the characteristic presentation of symptoms with difficulty swallowing and food bolus impaction has raised key concerns of clinicians as well as researchers. EoE often presents with dysphagia, food impaction, nausea, regurgitation or vomiting, and decreased appetite. It is more common in males, affecting both adults and children. The causative manner of this condition is complex and multifactorial. Throughout recent years, researchers have made a significant contribution to understanding the pathogenesis of EoE, genetic background, natural history, work on allergy, and standardization in the evaluation of disease activity. There is relatively high prevalence of EoE among the population, emphasizing the importance of this disease. Key messages: Esophageal involvement with eosinophils may be manifested as isolated or with coexisting conditions and should be taken into consideration in the differential diagnosis. This study aimed to provide gastroenterologists with novel insights into the evaluation of esophageal involvement with eosinophils and to pay special attention to the etiological factors, coexisting clinical diseases, and complications.

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Hepatic Portal Venous Gas: An Unusual Complication Following Upper Endoscopy and Dilation

Cited by 2 publications

References 6 publications

Vascular Injury Following Pyloric Dilation: Unusual Cause of Ischemic Colitis

Vascular Injury Following Pyloric Dilation: Unusual Cause of Ischemic Colitis

An Update on Eosinophilic Esophagitis: Etiological Factors, Coexisting Diseases, and Complications

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