Portal vein gas, a changing clinical entity. Report of 7 patients and review of the literature.
OBJECTIVE
To assess the clinical significance of portal vein gas (PVG) demonstrated by computed tomography (CT).


METHODS
Review of medical records.


METHODS
Three network-affiliated hospitals providing both primary community-based and tertiary services.


METHODS
Review of diagnosis, clinical circumstances, and significance of PVG in 7 patients detected by CT during a 3-year period in 3 affiliated hospitals.


RESULTS
Four of 7 patients underwent laparotomy; 1 patient refused surgery. Two patients were treated with intravenous antibiotics only and had uneventful clinical courses. Of the 3 patients who died, 1 refused and 2 underwent laparotomy.


CONCLUSIONS
This series indicates that more sensitive imaging and more widespread use of endoscopic retrograde cholangiopancreatography, colonoscopy, and liver transplantation have changed the clinical presentation of PVG; PVG may be found in various clinical settings that do not mandate laparotomy; and the significance of PVG must be derived from the clinical context of the individual patient.
Hong
J J
JJ
Department of Surgery, New York Hospital-Cornell Medical Center, New York, USA.
Gadaleta
D
D
Rossi
P
P
Esquivel
J
J
Davis
J M
JM
D000328:Adult; D000368:Aged; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed