Portal Vein Gas, a Changing Clinical EntityReport of 7 Patients and Review of the Literature
John J. Hong, MD;
Dominick Gadaleta, MD;
Peter Rossi, MD;
Jesus Esquivel, MD;
John Mihran Davis, MD
Arch Surg. 1997;132(10):1071-1075.
Abstract
Objective
To assess the clinical significance of portal vein gas (PVG) demonstrated by computed tomography (CT).
Design
Review of medical records.
Setting
Three network-affiliated hospitals providing both primary community-based and tertiary services.
Methods
Review of diagnosis, clinical circumstances, and significance of PVG in 7 patients detected by CT during a 3-year period in 3 affiliated hospitals.
Results
Four of 7 patients underwent laparotomy; 1 patient refused surgery. Two patients were treated with intravenous antibiotics only and had uneventful clinical courses. Of the 3 patients who died, 1 refused and 2 underwent laparotomy.
Conclusions
This series indicates that more sensitive imaging and more widespread use of endoscopic retrograde cholangiopancreatography, colonoscopy, and liver transplantation have changed the clinical presentation of PVG; PVG may be found in various clinical settings that do not mandate laparotomy; and the significance of PVG must be derived from the clinical context of the individual patient.
Arch Surg. 1997;132:1071-1075
Author Affiliations
From the Departments of Surgery, The New York Hospital—Cornell Medical Center, New York, NY (Drs Hong and Davis); the North Shore University Hospital, Manhasset, NY (Drs Gadaleta and Rossi); and The New York Hospital Medical Center of Queens, Queens (Dr Esquivel).
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