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Clinical Features and Management of Hepatic Portal Venous Gas
Four Case Reports and Cumulative Review of the Literature
Hiroyuki Kinoshita, MD;
Masahiro Shinozaki, MD;
Hiroshi Tanimura, MD;
Yoshiya Umemoto, MD;
Satoshi Sakaguchi, MD;
Katsunari Takifuji, MD;
Sadao Kawasaki, MD;
Hiroki Hayashi, MD;
Hiroki Yamaue, MD
Arch Surg. 2001;136:1410-1414.
Hypothesis Hepatic portal venous gas (HPVG) has been considered a rare entity associated with a grave prognosis. Since 1978, when Liebman et al reviewed 64 cases of HPVG and reported a mortality of 75%, the number of reported cases has been increasing.
Design Case series.
Patients and Methods We reviewed the literature on 182 cases of HPVG in adults, including 4 of our patients, (transplantation and abdominal trauma cases were excluded) and analyzed the cause, pathogenesis, and clinical features.
Results In this series, the underlying clinical events associated with HPVG were bowel necrosis (43%), digestive tract dilatation (12%), intraperitoneal abscess (11%), ulcerative colitis (4%), gastric ulcer (4%), Crohn disease (4%), complications of endoscopic procedures (4%), intraperitoneal tumor (3%), and other (15%). The overall mortality was 39% but varied depending on the underlying disease.
Conclusions Hepatic portal venous gas is a lethal or curable entity caused by various diseases. The underlying disease associated with HPVG determines the clinical features and prognosis of the patients. The treatment of patients with HPVG should be directed to the underlying disease.
From the Critical Care Medical Center (Drs Kinoshita, Shinozaki, Umemoto, Sakaguchi, Kawasaki, and Hayashi), and Second Department of Surgery, School of Medicine, Wakayama Medical University (Drs Kinoshita, Tanimura, Umemoto, Sakaguchi, Takifuji, and Yamaue), Wakayama, Japan.
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Radiofrequency Ablation of Liver Tumors: A New Cause of Benign Portal Venous Gas
Oei et al.
Radiology 2005;237:709-717.
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