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Arch Surg. 2008;143(8):804.

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Answer: Benign Portal Venous Gas

Portal venous gas (PVG) has historically been associated with acute abdominal catastrophe and high mortality rates. Noted radiographically first in neonates¹ and later in adults,² PVG has portended a uniformly fatal prognosis. Most commonly found with pneumatosis intestinalis, PVG has indicated the late stages of mesenteric ischemia and has traditionally mandated immediate operative exploration.³ With recent advances in radiological techniques and the ubiquity of CT scans, PVG has been associated with other types of abdominal pathological findings including bowel obstruction, inflammatory bowel disease, and pancreatitis; intra-abdominal infections such as diverticulitis, cholangitis, and portal pyelophlebitis; and various invasive endoscopic and intravascular procedures such as esophagogastroduodenoscopy, endoscopic retrograde cholangiopancreatography, colonoscopy, CT-guided abscess drainage, and visceral artery embolizations.⁴ Owing to lower mortality rates, PVG has been managed nonoperatively with greater success, calling into question mandatory surgery.⁵ The recent decrease in mortality rates may be due to the greater sensitivity of CT scans when . . . [Full Text of this Article]

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Arch Surg. 2008;143(8):803.
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