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Published in: International Journal of Colorectal Disease 11/2007

01-11-2007 | Case Report

Intermittent hepatic portal vein gas complicating diverticulitis—a case report and literature review

Authors: Franz Sellner, Babak Sobhian, Martina Baur, Stephanie Sellner, Barbara Horvath, Margit Mostegel, Josef Karner, Stefan Staettner

Published in: International Journal of Colorectal Disease | Issue 11/2007

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Abstract

Case report

This report describes a case of intermittent hepatic portal venous gas (HPVG) because of colonic diverticulitis in a 48-year-old man, who was successfully treated by surgery.

Conclusion

Based on an extensive literature search, which produced 21 observations, the etiology, symptoms, imaging features, clinical significance, treatment strategy, and outcome of HPVG because of colonic diverticulitis are evaluated: While observations with an underlying intramesocolic abscess carry a favorable prognosis, the prognosis of observations because of septic thrombophlebitis with gas forming germs is poor.
Literature
1.
go back to reference Sonnenshein M, Cone L, Alexander R (1986) Diverticulitis with colovenous fistula and portal venous gas. Report of two cases. J Clin Gastroenterol 8:195–198CrossRefPubMed Sonnenshein M, Cone L, Alexander R (1986) Diverticulitis with colovenous fistula and portal venous gas. Report of two cases. J Clin Gastroenterol 8:195–198CrossRefPubMed
2.
go back to reference Graham G, Bernstein R, Gronner A (1975) Gas in the portal and inferior mesenteric veins caused by diverticulitis of the sigmoid colon. Report of a case with survival. Radiology 114:601–602CrossRefPubMed Graham G, Bernstein R, Gronner A (1975) Gas in the portal and inferior mesenteric veins caused by diverticulitis of the sigmoid colon. Report of a case with survival. Radiology 114:601–602CrossRefPubMed
3.
go back to reference Fataar S, Cadogan E, Spruyt O (1986) Ultrasonography of hepatic portal vein gas due to diverticulitis. Br J Radiol 59:183–185CrossRefPubMed Fataar S, Cadogan E, Spruyt O (1986) Ultrasonography of hepatic portal vein gas due to diverticulitis. Br J Radiol 59:183–185CrossRefPubMed
4.
go back to reference Jensen JA, Tsang D, Minnis JF, Ponn Th, Merell RC (1985) Pyelophlebitis and intramesocolic perforation. Am J Surg 150:284–287CrossRefPubMed Jensen JA, Tsang D, Minnis JF, Ponn Th, Merell RC (1985) Pyelophlebitis and intramesocolic perforation. Am J Surg 150:284–287CrossRefPubMed
5.
go back to reference Haak H, Kooymans-Coutinho M, von Teeffelen M, Adhin N, Falke T (1990) Portal venous gas in a patient with diverticulitis. Hepatogastroenterology 37:528–529PubMed Haak H, Kooymans-Coutinho M, von Teeffelen M, Adhin N, Falke T (1990) Portal venous gas in a patient with diverticulitis. Hepatogastroenterology 37:528–529PubMed
6.
go back to reference Zielke A, Hasse C, Rothmund M (1998) Hepatic-portal venous gas in acute colonic diverticulitis. Surg Endosc 12:278–280CrossRefPubMed Zielke A, Hasse C, Rothmund M (1998) Hepatic-portal venous gas in acute colonic diverticulitis. Surg Endosc 12:278–280CrossRefPubMed
7.
go back to reference Maher M, Tonra M, Malone D, Gibney RG (2001) Portal. venous gas: detection by gray-scale and Doppler sonography in the absence of correlative findings on computed tomography. Abdom Imaging 26:390–394CrossRefPubMed Maher M, Tonra M, Malone D, Gibney RG (2001) Portal. venous gas: detection by gray-scale and Doppler sonography in the absence of correlative findings on computed tomography. Abdom Imaging 26:390–394CrossRefPubMed
8.
go back to reference Wiesner W, Mortele K, Glickman J, Ji H, Ros P (2001) Pneumatosis intestinalis and portomesenteric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. Am J Roentgenol 177:1319–1323CrossRef Wiesner W, Mortele K, Glickman J, Ji H, Ros P (2001) Pneumatosis intestinalis and portomesenteric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. Am J Roentgenol 177:1319–1323CrossRef
9.
go back to reference Dyer E, Faragher I (2005) Computer tomography finding of portal venous gas in a patient who survived mesenteric infarction. ANZ J Surg 75:363–364CrossRefPubMed Dyer E, Faragher I (2005) Computer tomography finding of portal venous gas in a patient who survived mesenteric infarction. ANZ J Surg 75:363–364CrossRefPubMed
10.
go back to reference Fukumori D, Sasaki T, Matsumoto H, Ohmori H, Kakazu T, Yamamoto F (2003) Necrotizing enteritis with hepatic portal vein gas and pneumatosis intestini: report of a case. Eur J Gastroenterol Hepatol 15:201–203CrossRefPubMed Fukumori D, Sasaki T, Matsumoto H, Ohmori H, Kakazu T, Yamamoto F (2003) Necrotizing enteritis with hepatic portal vein gas and pneumatosis intestini: report of a case. Eur J Gastroenterol Hepatol 15:201–203CrossRefPubMed
11.
12.
go back to reference Faberman R, Mayo-Smith W (1997) Outcome of 17 patients with portal venous gas detected by CT. Am J Roentgenol 169:1535–1538CrossRef Faberman R, Mayo-Smith W (1997) Outcome of 17 patients with portal venous gas detected by CT. Am J Roentgenol 169:1535–1538CrossRef
13.
go back to reference Brown M, Hauschildt J, Casola G, Gosink B, Hoyt D (1999) Intravascular gas as an incidental finding at US after blunt abdominal trauma. Radiology 210:2423–2425CrossRef Brown M, Hauschildt J, Casola G, Gosink B, Hoyt D (1999) Intravascular gas as an incidental finding at US after blunt abdominal trauma. Radiology 210:2423–2425CrossRef
14.
go back to reference Sebastia C, Quiroga S, Espin E, Boye R, Alvarez-Castells A, Armengol M (2000) Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis. Radiographics 20:1213–1224CrossRefPubMed Sebastia C, Quiroga S, Espin E, Boye R, Alvarez-Castells A, Armengol M (2000) Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis. Radiographics 20:1213–1224CrossRefPubMed
15.
go back to reference Furuya Y, Yasuhara H, Ariki K, Yanagie H, Naka S, Nojiri T, Nagao T (2002) Hepatic portal vein gas caused by blunt abdominal trauma. Is it true an ominous sign of bowel necrosis? Report of a case. Surg Today 32:655–658CrossRefPubMed Furuya Y, Yasuhara H, Ariki K, Yanagie H, Naka S, Nojiri T, Nagao T (2002) Hepatic portal vein gas caused by blunt abdominal trauma. Is it true an ominous sign of bowel necrosis? Report of a case. Surg Today 32:655–658CrossRefPubMed
16.
go back to reference Hong J, Gadaleta D, Rossi P, Esquivel J, Davis JM (1997) Portal vein gas, a changing clinical entity. Report of 7 patients and review of the literature. Arch Surg 132:1071–1075CrossRefPubMed Hong J, Gadaleta D, Rossi P, Esquivel J, Davis JM (1997) Portal vein gas, a changing clinical entity. Report of 7 patients and review of the literature. Arch Surg 132:1071–1075CrossRefPubMed
17.
18.
go back to reference Quirke TE (1995) Hepatic-portal venous gas associated with ileus. Am Surg 61:1084–1086PubMed Quirke TE (1995) Hepatic-portal venous gas associated with ileus. Am Surg 61:1084–1086PubMed
19.
go back to reference Venogopal C, Colley DP (1990) Portal venous gas in a patient with Crohn’s disease. J Clin Gastroenterol 12:595–597CrossRef Venogopal C, Colley DP (1990) Portal venous gas in a patient with Crohn’s disease. J Clin Gastroenterol 12:595–597CrossRef
20.
go back to reference Birnberg F, Gore R, Shragg B, Margulis A (1983) Hepatic portal venous gas: a benign finding in a patient with ulcerative colitis. J Clin Gastroenterol 5:89–91CrossRefPubMed Birnberg F, Gore R, Shragg B, Margulis A (1983) Hepatic portal venous gas: a benign finding in a patient with ulcerative colitis. J Clin Gastroenterol 5:89–91CrossRefPubMed
21.
go back to reference Wiesner W, Mortele K, Glickman J, Ji H, Ros P (2002) Portal-venous gas unrelated to mesenteric ischemia. Eur Radiol 12:1432–1437CrossRefPubMed Wiesner W, Mortele K, Glickman J, Ji H, Ros P (2002) Portal-venous gas unrelated to mesenteric ischemia. Eur Radiol 12:1432–1437CrossRefPubMed
22.
go back to reference Schilling E, Stückle C, Kirchner J, Donnerstag F, Liermann D (2000) Computerized tomography detection of portal vein air accumulation in severe gastroenteritis during chemotherapy. Wien Klin Wochenschr 112:80–83PubMed Schilling E, Stückle C, Kirchner J, Donnerstag F, Liermann D (2000) Computerized tomography detection of portal vein air accumulation in severe gastroenteritis during chemotherapy. Wien Klin Wochenschr 112:80–83PubMed
23.
go back to reference Levin M, Pocard M, Caplin S, Blain A, Tubiana JM, Parc R (2002) Benign hepatic portal venous gas following caustic ingestion. Eur Radiol 12:59–61 Levin M, Pocard M, Caplin S, Blain A, Tubiana JM, Parc R (2002) Benign hepatic portal venous gas following caustic ingestion. Eur Radiol 12:59–61
24.
go back to reference North JH, Nava HR (1995) Pneumatosis intestinalis and portal venous air associated with needle catheter jejunostomy. Am Surg 61:1045104–1045108 North JH, Nava HR (1995) Pneumatosis intestinalis and portal venous air associated with needle catheter jejunostomy. Am Surg 61:1045104–1045108
25.
go back to reference Kees CJ, Hester CL (1972) Portal vein gas following barium enema examination. Radiology 102:525–526CrossRefPubMed Kees CJ, Hester CL (1972) Portal vein gas following barium enema examination. Radiology 102:525–526CrossRefPubMed
26.
go back to reference Herron D, Vernon J, Gryska P, Reines H (1999) Venous gas embolism during endoscopy. Surg Endosc 13:276–279CrossRefPubMed Herron D, Vernon J, Gryska P, Reines H (1999) Venous gas embolism during endoscopy. Surg Endosc 13:276–279CrossRefPubMed
27.
go back to reference Blind PJ, Oberg L, Hedberg B (1991) Hepatic portal vein gas following endoscopic retrograde cholangiography with sphincterotomy. Eur J Surg 157:299–300PubMed Blind PJ, Oberg L, Hedberg B (1991) Hepatic portal vein gas following endoscopic retrograde cholangiography with sphincterotomy. Eur J Surg 157:299–300PubMed
28.
go back to reference Chezmar J, Nelson R, Bernardino M (1989) Portal venous gas after hepatic transplantation; sonographic detection and clinical significance. Am J Roentgenol 153:1203–1205CrossRef Chezmar J, Nelson R, Bernardino M (1989) Portal venous gas after hepatic transplantation; sonographic detection and clinical significance. Am J Roentgenol 153:1203–1205CrossRef
29.
go back to reference Najafian H, Habibi M, Reilly T (2003) Hepatic portal vein gas: clinical features and outcomes. Am Surg 69:526–529PubMed Najafian H, Habibi M, Reilly T (2003) Hepatic portal vein gas: clinical features and outcomes. Am Surg 69:526–529PubMed
30.
go back to reference Hou S, Chern C, How C, Chen J, Wang L, Lee C (2004) Hepatic portal vein gas: clinical significance of computed tomography findings. Am J Emerg Med 22:214–218CrossRefPubMed Hou S, Chern C, How C, Chen J, Wang L, Lee C (2004) Hepatic portal vein gas: clinical significance of computed tomography findings. Am J Emerg Med 22:214–218CrossRefPubMed
31.
go back to reference Brandon T, Bogart B, ReMine S, Urban L (2000) Early recognition of hepatic portal vein gas on CT with appropriate surgical intervention improves patient survival. Curr Surg 57:452–455CrossRefPubMed Brandon T, Bogart B, ReMine S, Urban L (2000) Early recognition of hepatic portal vein gas on CT with appropriate surgical intervention improves patient survival. Curr Surg 57:452–455CrossRefPubMed
32.
go back to reference Cambria R, Margolies M (1982) Hepatic portal vein gas in diverticulitis: survival in a steroid treated case. Arch Surg 117:834–835CrossRefPubMed Cambria R, Margolies M (1982) Hepatic portal vein gas in diverticulitis: survival in a steroid treated case. Arch Surg 117:834–835CrossRefPubMed
33.
go back to reference Burgard G, Cuilleron M, Cuilleret J (1993) An unusual complication of perforated sigmoid diverticulitis: gas in the portal vein with miliary liver abscesses. J Chir (Paris) 130:237–239 Burgard G, Cuilleron M, Cuilleret J (1993) An unusual complication of perforated sigmoid diverticulitis: gas in the portal vein with miliary liver abscesses. J Chir (Paris) 130:237–239
34.
go back to reference Rossmann M, Burr L, Thorpe P (1997) Colovenous fistula complicating diverticulitis: CT and radiographic findings. Abdom Imaging 22:513–515CrossRefPubMed Rossmann M, Burr L, Thorpe P (1997) Colovenous fistula complicating diverticulitis: CT and radiographic findings. Abdom Imaging 22:513–515CrossRefPubMed
35.
go back to reference Häner C, Inderbitzi R, Badulescu M, Teucher J (1998) Septic pylephlebitis with detection of gas in the portal vein: a rare complication of sigmoid diverticulitis. Schweiz Med Wochenschr 128:1339–1344PubMed Häner C, Inderbitzi R, Badulescu M, Teucher J (1998) Septic pylephlebitis with detection of gas in the portal vein: a rare complication of sigmoid diverticulitis. Schweiz Med Wochenschr 128:1339–1344PubMed
36.
go back to reference Heye S, Ghijselinos L, van Campenhoudt M (2002) Hepatic portal main gas as a complication of diverticulitis with a colovenous fistula: a case report. Emerg Radiol 9:234–236PubMed Heye S, Ghijselinos L, van Campenhoudt M (2002) Hepatic portal main gas as a complication of diverticulitis with a colovenous fistula: a case report. Emerg Radiol 9:234–236PubMed
37.
go back to reference D’Angelo M (2003) Case of the month. Diverticulitis with portomesenteric vein gas. Crit Rev Comput Tomogr 44:315–320CrossRefPubMed D’Angelo M (2003) Case of the month. Diverticulitis with portomesenteric vein gas. Crit Rev Comput Tomogr 44:315–320CrossRefPubMed
38.
go back to reference White T, Allen H, Ives C (1998) Portal and mesenteric vein gas in diverticulitis: CT findings. Am J Roentegenol 71:525–526CrossRef White T, Allen H, Ives C (1998) Portal and mesenteric vein gas in diverticulitis: CT findings. Am J Roentegenol 71:525–526CrossRef
39.
go back to reference Ai-Toma A, Nix M, Brink M (2004) Image of the month: diverticulitis of the sigmoid colon. Gastroenterology 126:393, 634CrossRef Ai-Toma A, Nix M, Brink M (2004) Image of the month: diverticulitis of the sigmoid colon. Gastroenterology 126:393, 634CrossRef
40.
go back to reference Yochida M, Mitsuo M, Kutsumi H, Fujita T, Soga T, Nishimura K, Kawabata K, Kadotani Y, Kinoshita Y, Chiba T, Kuroiwa N, Fujimoto S (1995) A successfully treated case of multiple liver abscesses accompanied by portal vein gas. Am J Gastroenterol 91:2423–2425 Yochida M, Mitsuo M, Kutsumi H, Fujita T, Soga T, Nishimura K, Kawabata K, Kadotani Y, Kinoshita Y, Chiba T, Kuroiwa N, Fujimoto S (1995) A successfully treated case of multiple liver abscesses accompanied by portal vein gas. Am J Gastroenterol 91:2423–2425
Metadata
Title
Intermittent hepatic portal vein gas complicating diverticulitis—a case report and literature review
Authors
Franz Sellner
Babak Sobhian
Martina Baur
Stephanie Sellner
Barbara Horvath
Margit Mostegel
Josef Karner
Stefan Staettner
Publication date
01-11-2007
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 11/2007
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-007-0346-3

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