title: Portal vein gas, a changing clinical entity. Report of 7 patients and review of the literature.
abstract: 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.
authors.affiliation: Department of Surgery, New York Hospital-Cornell Medical Center, New York, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Hong
authors.forename: D
authors.initials: D
authors.lastname: Gadaleta
authors.forename: P
authors.initials: P
authors.lastname: Rossi
authors.forename: J
authors.initials: J
authors.lastname: Esquivel
authors.forename: J M
authors.initials: JM
authors.lastname: Davis
mesh_terms: 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