Hepatic portal gas in adults: review of the literature and presentation of a consecutive series of 11 cases

Details

Serval ID
serval:BIB_4CA0D173A890
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Hepatic portal gas in adults: review of the literature and presentation of a consecutive series of 11 cases
Journal
Archives of Surgery
Author(s)
Peloponissios  N., Halkic  N., Pugnale  M., Jornod  P., Nordback  P., Meyer  A., Gillet  M.
ISSN
0004-0010 (Print)
Publication state
Published
Issued date
2003
Volume
138
Number
12
Pages
1367-1370
Notes
DA - 20031209 LA - eng PT - Case Reports PT - Journal Article PT - Review SB - AIM SB - IM
Abstract
BACKGROUND: Hepatic portal venous gas (HPVG) in adults is a rare entity. The underlying pathologic condition is usually an intestinal ischemia, but it has been reported in association with a variety of conditions. HYPOTHESIS: Miscomprehension of the underlying pathologic conditions has led to some confusion in the literature concerning its etiology, diagnostic methods, and clinical consequences. SETTING: Centre Hospitalier et Universitaire Vaudois, Lausanne, Switzerland, and District Hospital of Morges, Morges, Switzerland. METHOD: Between February 1, 1995, and May 30, 2000, eleven cases of HPVG were treated. These cases were retrospectively reviewed, together with a review of the literature to define the clinical significance of HPVG, the role of the computed tomographic scan, and the necessity of performing systematic emergency exploratory surgery. RESULTS: Two groups have to be distinguished-those who have HPVG with associated pneumatosis intestinalis and those who have HPVG without associated pneumatosis intestinalis. When associated with pneumatosis intestinalis, the cause is usually an intestinal ischemia and in a symptomatic patient it justifies systematic exploratory surgery. An abdominal computed tomographic scan including lung window settings to better identify air in the bowel wall will distinguish between these 2 groups. Pneumatosis intestinalis and HPVG due to bowel ischemia do not allow prediction of the severity of bowel wall damage. CONCLUSIONS: The cause of HPVG without pneumatosis intestinalis is variable. Good knowledge of the possible causes combined with the clinical picture and the abdominal computed tomographic scan is required to correctly identify the underlying cause of HPVG and to avoid unnecessary surgery
Keywords
Adult/Aged/Aged,80 and over/Female/Hepatic Veins/Humans/Male/Middle Aged/Pneumatosis Cystoides Intestinalis/radiography/Portal Vein/Retrospective Studies/Tomography,X-Ray Computed
Pubmed
Web of science
Open Access
Yes
Create date
18/02/2008 14:30
Last modification date
20/08/2019 15:01
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