Is hepatic portal venous gas an indication for exploratory laparotomy?
L. W. Traverso
Three patients with roentgenographic evidence of hepatic portal venous gas
(HPVG) were hospitalized within a one-month period at one hospital. The
abdominal roentgenograms were obtained because the clinical signs of
abdominal rigidity, distention, or both were present. Each patient had
exploratory laparotomy after the HPVG was seen. During the operations,
extensive cyanotic/necrotic bowel was found. The patients died within a few
hours after the procedures. These cases bring the total to 67 cases in the
retrievable literature. One quarter of the patients described have
survived; none of them had extensive bowel necrosis associated with their
HPVG. In order to determine the extent of bowel necrosis associated with
HPVG, and to determine if treatment is possible, an exploratory laparotomy
should be performed.
