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Erschienen in: Digestive Diseases and Sciences 10/2021

29.06.2021 | DDS–SIRC COOPERATIVE CONFERENCES

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

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

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2021

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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.
Literatur
1.
Zurück zum Zitat 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 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.
Zurück zum Zitat Deng-Wei C, Keh-Cherng W. Emphysematous liver abscess with hepatic portal venous gas. Intern Emerg Med. 2019;14:1335–1336.CrossRef Deng-Wei C, Keh-Cherng W. Emphysematous liver abscess with hepatic portal venous gas. Intern Emerg Med. 2019;14:1335–1336.CrossRef
3.
Zurück zum Zitat 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). 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.
Zurück zum Zitat Tang CM, Yarandi SS, Laxton WH et al. Conservative management of gastric emphysema with hepatoportal venous gas. BMJ Case Rep. 2015;2015:bcr2015211669.PubMedPubMedCentralCrossRef 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.
Zurück zum Zitat 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. 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.
Zurück zum Zitat Fredy N, Kyle R, Imad N. Emphysematous gastritis with hepatic portal venous gas: a shift towards conservative management. BMJ Case Rep. 2017;2017:bcr2017219651. 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Shipman PJ, Drury P. Emphysematous gastritis: case report and literature review. Australas Radiol. 2001;45:64–66.PubMedCrossRef Shipman PJ, Drury P. Emphysematous gastritis: case report and literature review. Australas Radiol. 2001;45:64–66.PubMedCrossRef
10.
Zurück zum Zitat 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 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.
Zurück zum Zitat Sho S, Yoji T, Ryu I et al. Hepatic portal venous gas following colonic endoscopic submucosal dissection. Intern Med 2019;58:755–756.CrossRef 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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. 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.
Zurück zum Zitat Singavi AK, Shah NN. Graft-versus-host disease-associated hepatic portal venous gas. Br J Haematol 2018;181:9.PubMedCrossRef Singavi AK, Shah NN. Graft-versus-host disease-associated hepatic portal venous gas. Br J Haematol 2018;181:9.PubMedCrossRef
17.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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). 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Fangmei L, Di G, Liangru Z. Pneumatosis cystoides intestinalis: a case report and literature review. BMC Gastroenterol 2019;19:176.CrossRef Fangmei L, Di G, Liangru Z. Pneumatosis cystoides intestinalis: a case report and literature review. BMC Gastroenterol 2019;19:176.CrossRef
22.
Zurück zum Zitat Alemi F, Seiser N, Ayloo S. Gallstone disease: cholecystitis, mirizzi syndrome, bouveret syndrome, gallstone ileus. Surg Clin North Am 2019;99:231–244.PubMedCrossRef Alemi F, Seiser N, Ayloo S. Gallstone disease: cholecystitis, mirizzi syndrome, bouveret syndrome, gallstone ileus. Surg Clin North Am 2019;99:231–244.PubMedCrossRef
26.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat Bernstein BS, Callan RG, Bernstein DE et al. Hepatic portal venous gas: acute deterioration in an elderly patient. J Surg Case Rep 2017;2017:rjx245.PubMedPubMedCentralCrossRef Bernstein BS, Callan RG, Bernstein DE et al. Hepatic portal venous gas: acute deterioration in an elderly patient. J Surg Case Rep 2017;2017:rjx245.PubMedPubMedCentralCrossRef
29.
Zurück zum Zitat Ito M, Horiguchi A, Miyakawa S. Pneumatosis intestinalis and hepatic portal venous gas. J Hepatobiliary Pancreat Surg 2008;15:334–337.PubMedCrossRef Ito M, Horiguchi A, Miyakawa S. Pneumatosis intestinalis and hepatic portal venous gas. J Hepatobiliary Pancreat Surg 2008;15:334–337.PubMedCrossRef
30.
Zurück zum Zitat 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 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
32.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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.
Zurück zum Zitat 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 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
42.
Zurück zum Zitat 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 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.
Zurück zum Zitat Franca E, Shaydakov ME, Kosove J. Mesenteric Artery Thrombosis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. Franca E, Shaydakov ME, Kosove J. Mesenteric Artery Thrombosis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
Metadaten
Titel
Gas in the Portal Vein: An Emergency or Just Hot Air?
verfasst von
N. Zorzetti
A. Lauro
A. Ruffato
V. D’Andrea
L. Ferruzzi
N. Antonacci
R. M. Tranchino
Publikationsdatum
29.06.2021
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 10/2021
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-021-07126-8

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