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Review
. 2020 Jul 12:21:e923831.
doi: 10.12659/AJCR.923831.

Pneumatosis Intestinalis and Hepatic Portal Venous Gas: Watch and Wait or Emergency Surgery? A Case Report and Literature Review

Rigers Dibra  1 , Arcangelo Picciariello  1 , Giuseppe Trigiante  1 , Grazia Labellarte  1 , Giovanni Tota  1 , Vincenzo Papagni  1 , Gennaro Martines  1 , Donato F Altomare  1
Affiliations
Review

Pneumatosis Intestinalis and Hepatic Portal Venous Gas: Watch and Wait or Emergency Surgery? A Case Report and Literature Review

Rigers Dibra et al. Am J Case Rep. .

Abstract

BACKGROUND Hepatic portal venous gas (HPVG) associated with pneumatosis intestinalis (PI) can be indicative of several diseases, including inflammatory bowel disease (IBD), infective and obstructive gastrointestinal conditions, and also potentially life-threatening situations such as mesenteric ischemia. CASE REPORT A 60-year-old female patient came to our attention with evidence at computed tomography (CT) scan of gas in the portal vein and bowel walls with no sign of ischemia. General tenderness of the abdomen with absence of bowel sounds was detected at the physical examination. An exploratory laparotomy was performed with evidence of mesenteric ischemia. CONCLUSIONS Emergency surgery should be indicated when CT signs of PI and HPVG occur along with a clinical situation strongly suggestive of bowel ischemia, even with no radiological sign of this critical condition.

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Conflict of interest statement

Conflict of interest: None declared

Conflict of interest

None.

Figures

Figure 1.
Figure 1.
Arrows indicate the presence of air into the ileal loop wall.
Figure 2.
Figure 2.
Arrows point air inside the distal portal system.
Figure 3.
Figure 3.
Resected bowel with signs of necrosis.
See this image and copyright information in PMC

References

    1. Di Pietropaolo M, Trinci M, Giangregorio C, et al. Pneumatosis cystoides intestinalis: Case report and review of literature. Clin J Gastroenterol. 2020;13(1):31–36. - PubMed
    1. Morris MS, Gee AC, Cho SD, et al. Management and outcome of pneumatosis intestinalis. Am J Surg. 2008;195(5):679–82. ; discussion 682–83. - PubMed
    1. Wang YJ, Wang YM, Zheng YM, et al. Pneumatosis cystoides intestinalis: Six case reports and a review of the literature. BMC Gastroenterol. 2018;18(1):100. - PMC - PubMed
    1. Wu LL, Yang YS, Dou Y, Liu QS. A systematic analysis of pneumatosis cystoids intestinalis. World J Gastroenterol. 2013;19(30):4973–78. - PMC - PubMed
    1. Sebastia C, Quiroga S, Espin E, et al. Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis. Radiographics. 2000;20(5):1213–24. ; discussion 1224–26. - PubMed