CT detection of portal venous gas associated with suppurative cholangitis and cholecystitis

Background Gastrointestinal (GI) perforation is a risk factor for mortality in very low birth weight (VLBW) infants. Little data exist regarding pretreatment factors and patient characteristics known to independently correlate with risk of death. Materials and Methods A retrospective review of all VLBW infants who sustained GI perforation between 2011 and 2018 was conducted. Birth, laboratory, and disease-related factors of infants who died were compared to those who survived. Results 42 VLBW infants who sustained GI perforations were identified. Eleven (26.19%) died. There were no significant differences in birth-related factors, hematological lab levels at diagnosis, presence of pneumatosis, or bacteremia. Portal venous gas ( P = .03), severe metabolic acidosis ( P < .01), and elevated lactate at diagnosis ( P < .01) were statistically more likely to occur among infants who died. Discussion Portal venous gas, severe metabolic acidosis, and elevated lactate were associated with an increased risk of mortality among VLBW infants who develop a GI perforation. Further research is required to better identify risk factors.

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Conservative treatment of hepatic portal venous gas resulting from non-occlusive mesenteric ischemia: a case report

Clinical Journal of Gastroenterology ◽

10.1007/s12328-021-01468-6 ◽

2021 ◽

Author(s):

Takuya Seike ◽

Tusyoshi Suda ◽

Naoki Oishi

Keyword(s):

Case Report ◽

Conservative Treatment ◽

Mesenteric Ischemia ◽

Hepatic Portal Venous Gas ◽

Portal Venous Gas ◽

Occlusive Mesenteric Ischemia ◽

Hepatic Portal

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A case of portal venous gas after obstructive transverse colon cancer surgery

Surgical Case Reports ◽

10.1186/s40792-019-0729-z ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Yuichiro Furutani ◽

Chikashi Hiranuma ◽

Masakazu Hattori ◽

Kenji Doden ◽

Yasuo Hashizume

Keyword(s):

Colon Cancer ◽

Conservative Treatment ◽

Anastomotic Leakage ◽

Transverse Colon ◽

Cancer Surgery ◽

Transverse Colon Cancer ◽

Bowel Necrosis ◽

Entire Area ◽

Portal Venous Gas ◽

Colon Cancer Surgery

Abstract Background Portal venous gas has traditionally been considered an inevitable harbinger of death due to its association with bowel necrosis. Recently, an increasing number of cases of portal venous gas have been reported in patients with various clinical conditions and without bowel necrosis. We herein report the case of a patient in whom portal venous gas developed after transverse colon cancer surgery. Case presentation A 69-year-old man who had transverse colon cancer underwent insertion of a transanal ileus tube for decompression. Transverse colon resection was performed on the 11th day after the insertion of the transanal ileus tube. The patient had a high fever on the 6th day after the operation. Computed tomography showed portal venous gas over the entire area of the liver and pneumatosis intestinalis in the wall of the ascending colon. There were no signs of anastomotic leakage or bowel necrosis, so we decided to use conservative therapy with fasting and antibiotics. The portal venous gas disappeared on the 19th day after the operation. The patient was discharged in good condition on the 29th day after the operation. Conclusions Conservative treatment for portal venous gas is reasonable for patients without signs of anastomotic leakage or bowel necrosis. However, it is important to carefully observe patients with portal venous gas during conservative treatment because portal venous gas may be life-threatening.

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