A Case Report on Hepatic Portal Venous Gas (HPVG)

Abstract

Hepatic Portal Venous Gas (HPVG) is the abnormal presence of gas in the portal venous system. It is associated with life-threatening conditions and is a sinister radiological sign. This case report aims to evaluate the significance of HPVG as a radiological sign. Our case involves a 49-year-old man who was admitted to the hospital following a one-day history of severe epigastric pain and haematemesis. Investigations showed extensive HPVG, gastric pneumatosis, a large retroperitoneal haematoma, and an obstructive lesion between the first and second part of the duodenum. Our patient was managed conservatively in the High Dependency Unit (HDU). A repeat Computerised Tomography (CT) scan showed successful resolution of the HPVG and gastric pneumatosis without any invasive intervention.

Keywords: gastric pneumatosis; gi radiology; git endoscopy; haematemesis; hepatic portal vein gas; hepatic portal venous gas; hpvg; pneumatosis intestinalis; portal venous gas.

Figure 1. CT Abdomen/Pelvis (axial view)

The image is showing HPVG (Hepatic Portal Venous Gas)

Figure 2. CT Abdomen/Pelvis (coronal view)

The image is showing HPVG (Hepatic Portal Venous Gas)

Figure 3. CT Abdomen/Pelvis (axial view)

The red arrow is showing the haematoma

Figure 4. CT Abdomen/Pelvis (coronal view)

The red arrow is showing the haematoma

Figure 5. Endoscopy image of the obstructive lesion at the D1/D2 junction

D1: the superior part of the duodenum; D2: the descending duodenum

Figure 6. CT Abdomen/Pelvis (axial view)

The image is showing resolution of the previous HPVG (Hepatic Portal Venous Gas)

Figure 7. CT Abdomen/Pelvis (coronal view)

The image is showing resolution of the previous HPVG (Hepatic Portal Venous Gas)