Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 10/2021

01-10-2021 | Visceral Ischemia | DDS–SIRC COOPERATIVE CONFERENCES

Gas in the Portal Vein: An Emergency or Just Hot Air?

Authors: N. Zorzetti, A. Lauro, A. Ruffato, V. D’Andrea, L. Ferruzzi, N. Antonacci, R. M. Tranchino

Published in: Digestive Diseases and Sciences | Issue 10/2021

Login to get access

Abstract

We report the case of a 87-year-old woman admitted to our Emergency Department for mild abdominal pain associated with vomiting. An abdominal X-ray showed gas present in the portal venules of the left hepatic lobe, a finding associated with numerous surgical and medical conditions. The patient was successfully managed with conservative treatment. Isolated intrahepatic gas is a rare radiologic finding; emergency surgery should be performed only when there are signs of associated acute intestinal infarction.
Literature
1.
Wolfe JN, Evans WA. Gas in the portal veins of the liver in infants; a roentgenographic demonstration with postmortem anatomical correlation. Am J Roentgenol Radium Ther Nucl Med. 1955;74:486–488.PubMed
2.
Deng-Wei C, Keh-Cherng W. Emphysematous liver abscess with hepatic portal venous gas. Intern Emerg Med. 2019;14:1335–1336.CrossRef
3.
Masaya I, Yuki O, Hiromitsu K et al. Conservative management of gastric emphysema and hepatic portal venous gas: a case report. Nihon Shokakibyo Gakkai Zasshi. 2018;115:655–661 (Article in Japanese).
4.
Tang CM, Yarandi SS, Laxton WH et al. Conservative management of gastric emphysema with hepatoportal venous gas. BMJ Case Rep. 2015;2015:bcr2015211669.PubMedPubMedCentralCrossRef
5.
Tadashi F, Takafumi U, Isao M et al. Non-surgical treatment of gastric emphysema with intra-abdominal free gas and hepatic portal venous gas: Lessons from a rare case. SAGE Open Med Case Rep. 2020;8:2050313X20945946.
6.
Fredy N, Kyle R, Imad N. Emphysematous gastritis with hepatic portal venous gas: a shift towards conservative management. BMJ Case Rep. 2017;2017:bcr2017219651.
7.
Ng A, Spanger M, Lubel JS. Education and imaging. Hepatobiliary and pancreatic: emphysematous gastritis with hepatic portal venous gas. J Gastroenterol Hepatol 2012;27:1130.PubMedCrossRef
8.
Takeshi Y, Nobuaki Y, Yuki N et al. A case of phlegmonous gastritis with hepatic portal venous gas caused by Aeromonas hydrophila successfully treated with medication. Clin J Gastroenterol 2020;13:281–286.CrossRef
9.
Shipman PJ, Drury P. Emphysematous gastritis: case report and literature review. Australas Radiol. 2001;45:64–66.PubMedCrossRef
10.
Capolupo GT, Mascianà G, Carannante F, Caricato M. Hepatic portal venous gas after colonoscopy: a case report and review. Int J Surg Case Rep 2018;51:54–57.PubMedPubMedCentralCrossRef
11.
Sho S, Yoji T, Ryu I et al. Hepatic portal venous gas following colonic endoscopic submucosal dissection. Intern Med 2019;58:755–756.CrossRef
12.
Toyoaki S, Tsuyoshi N, Masaharu T et al. Asymptomatic hepatic portal venous gas with gastric emphysema as a chronic complication of gastrostomy tube placement: a case report. J Med Case Rep 2016;10:234.CrossRef
13.
Sherin D, Denease F, Michelle T et al. Case of hepatic portal venous gas in an infant with hypertrophic pyloric stenosis. BMJ Case Rep 2018;2018:bcr2018224794.
14.
Dong-Guang N, Chen L, Hong-Chun F. Hepatic portal venous gas associated with transcatheter cardiac defibrillator implantation: a case report. Int J Surg Case Rep 2018;44:57–61.CrossRef
15.
Harith A, Mina D, Joseph B et al. Gastric Emphysema and Hepatic Portal Vein Gas as Complications of Noninvasive Positive Pressure Ventilation. Cureus 2020;12:e9086.
16.
Singavi AK, Shah NN. Graft-versus-host disease-associated hepatic portal venous gas. Br J Haematol 2018;181:9.PubMedCrossRef
17.
Junichiro Y, Riko H, Gen T et al. Hepatic portal venous gas associated with severe graft-versus-host disease of the gastrointestinal tract. Intern Med 2012;51:2417–2421.CrossRef
18.
19.
Makoto I, Kazuto O, Tetsuzo T et al. Case of portal venous gas and pneumatosis cystoides intestinalis occurring during chemotherapy for a castration-resistant prostate cancer. Hinyokika Kiyo 2014;60:575–578 (Article in Japanese).
20.
Kenta T, Hideyuki A, Ayuko Y et al. Improvements in pneumatosis cystoides intestinalis and hepatic portal venous gas with conservative therapy in a patient on maintenance dialysis. Intern Med 2016;55:1735–1738.CrossRef
21.
Fangmei L, Di G, Liangru Z. Pneumatosis cystoides intestinalis: a case report and literature review. BMC Gastroenterol 2019;19:176.CrossRef
22.
Alemi F, Seiser N, Ayloo S. Gallstone disease: cholecystitis, mirizzi syndrome, bouveret syndrome, gallstone ileus. Surg Clin North Am 2019;99:231–244.PubMedCrossRef
23.
24.
25.
26.
Tahara S, Sakai Y, Katsuno H et al. Pneumatosis intestinalis and hepatic portal venous gas associated with gas-forming bacterial translocation due to postoperative paralytic ileus: A case report. Medicine Baltimore 2019;98:e14079.PubMedPubMedCentralCrossRef
27.
Aslam F, Apostolopoulos A, Zeeshan S. Pneumatosis intestinalis with extensive intrahepatic portal venous gas secondary to intra-abdominal sepsis: a rare occurrence. BMJ Case Rep 2017;2017:bcr2017222865.PubMedCentralCrossRef
28.
29.
Ito M, Horiguchi A, Miyakawa S. Pneumatosis intestinalis and hepatic portal venous gas. J Hepatobiliary Pancreat Surg 2008;15:334–337.PubMedCrossRef
30.
Ohtsubo K, Okai T, Yamaguchi Y et al. Pneumatosis intestinalis and hepatic portal venous gas caused by mesenteric ischemia in an aged person. J Gastroenterol 2001;36:338–340.PubMedCrossRef
31.
32.
Chen H, Wu Q, Fang H et al. Intestinal necrosis cannot be neglected in a patient with hepatic portal vein gas combined with appendicitis: a rare case report and literature review. BMC Surg 2019;19:17.PubMedPubMedCentralCrossRef
33.
Li Z, Su Y, Wang X et al. Hepatic portal venous gas associated with colon cancer: a case report and literature review. Medicine (Baltimore) 2017;96:e9352.CrossRef
34.
35.
Schindera ST, Triller J, Vock P et al. Detection of hepatic portal venous gas: its clinical impact and outcome. Emerg Radiol 2006;12:164–170.PubMedCrossRef
36.
Chan SC, Wan YL, Cheung YC et al. Computed tomography findings in fatal cases of enormous hepatic portal venous gas. World J Gastroenterol 2005;11:2953–2955.PubMedPubMedCentralCrossRef
37.
Ginesu GC, Barmina M, Cossu ML et al. Conservative approach to hepatic portal venous gas: a case report. Int J Surg Case Rep 2017;30:183–185.PubMedCrossRef
38.
Nelson AL, Millington TM, Sahani D et al. Hepatic portal venous gas: the ABCs of management. Arch Surg 2009;144:575–581 (discussion 581).PubMedCrossRef
39.
Iannitti DA, Gregg SC, Mayo-Smith WW et al. Portal venous gas detected by computed tomography: is surgery imperative? Dig Surg 2003;20:306–315.PubMedCrossRef
40.
Sen-Kuang H, Chii-Hwa C, Chorng-Kuang H et al. Hepatic portal venous gas: clinical significance of computed tomography findings. Am J Emerg Med 2004;22:214–218.CrossRef
41.
42.
Navas-Campo R, Moreno-Caballero L, Ezponda Casajús A. Acute mesenteric ischemia: a review of the main imaging techniques and signs. Radiologia 2020;62:336–348.PubMedCrossRef
43.
Franca E, Shaydakov ME, Kosove J. Mesenteric Artery Thrombosis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
Metadata
Title
Gas in the Portal Vein: An Emergency or Just Hot Air?
Authors
N. Zorzetti
A. Lauro
A. Ruffato
V. D’Andrea
L. Ferruzzi
N. Antonacci
R. M. Tranchino
Publication date
01-10-2021
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 10/2021
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-021-07126-8

Other articles of this Issue 10/2021

Digestive Diseases and Sciences 10/2021 Go to the issue

Original Article

High-Fat Diet Induces Disruption of the Tight Junction-Mediated Paracellular Barrier in the Proximal Small Intestine Before the Onset of Type 2 Diabetes and Endotoxemia

Review

Importance of Hepcidin in the Etiopathogenesis of Anemia in Inflammatory Bowel Disease

Case Report

Gastric Antral Vascular Ectasia and Vitamin D Deficiency: New Associated Disease and Proposed Pathogenetic Mechanisms

Original Article

Inflammation, Tumoral Markers and Interleukin-17, -10, and -6 Profiles in Pancreatic Adenocarcinoma and Chronic Pancreatitis

Original Article

Impaired Quality of Life in Patients with Autoimmune Atrophic Gastritis

Original Article

Safety, Efficacy, and Long-Term Outcomes of Anticoagulation in Cirrhotic Portal Vein Thrombosis
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits