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Case Reports
. 2011 May 12:2011:bcr0720103206.
doi: 10.1136/bcr.07.2010.3206.

Portal venous gas: is it a premorbid indicator?

O Kailani  1 , M Farid, N Tewari, H T Khawaja
Affiliations
Case Reports

Portal venous gas: is it a premorbid indicator?

O Kailani et al. BMJ Case Rep. .

Abstract

A 72-year-old Caucasian man presented with subtle and insidious symptoms of pain in the left iliac fossa and vomiting. The first clinical impression was of diverticulitis but he did not improve with conservative management. An initial contrast tomography (CT) scan demonstrated no diagnostic features. Four days later, a repeat CT scan demonstrated intramural gas in the ascending colon and in the intrahepatic portal venous radicles. There was a thrombus in the superior mesenteric artery with infarction of the caecum and ascending colon. An urgent right hemicolectomy was carried out. Although there was resolution of the thrombus and air in the portal system, the patient died 8 days later from intestinal haemorrhage.

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Conflict of interest statement

Competing interests None.

Figures

Figure 1
Figure 1
(A) Coronal CT image showing marked dilatation of the large bowel with intramural gas collections within the ascending colon and caecum (arrows). (B) Coronal CT image showing air in the intramural intestinal wall and portal venous gas. (C) Axial CT image showing gas in the intrahepatic portal veins.
See this image and copyright information in PMC

References

    1. 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;74:486–8 - PubMed
    1. Susman N, Senturia HR. Gas embolization of the portal venous system. Am J Roentgenol Radium Ther Nucl Med 1960;83:847–50 - PubMed
    1. Liebman PR, Patten MT, Manny J, et al. Hepatic-portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg 1978;187:281–7 - PMC - PubMed
    1. Kinoshita H, Shinozaki M, Tanimura H, et al. Clinical features and management of hepatic portal venous gas: four case reports and cumulative review of the literature. Arch Surg 2001;136:1410–14 - PubMed
    1. Nelson AL, Millington TM, Sahani D, et al. Hepatic portal venous gas: the ABCs of management. Arch Surg 2009;144:575–81; discussion 581. - PubMed

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