Clinical features and management of hepatic portal venous gas: four case reports and cumulative review of the literature.
OBJECTIVE
Hepatic portal venous gas (HPVG) has been considered a rare entity associated with a grave prognosis. Since 1978, when Liebman et al reviewed 64 cases of HPVG and reported a mortality of 75%, the number of reported cases has been increasing.


METHODS
Case series.


METHODS
We reviewed the literature on 182 cases of HPVG in adults, including 4 of our patients, (transplantation and abdominal trauma cases were excluded) and analyzed the cause, pathogenesis, and clinical features.


RESULTS
In this series, the underlying clinical events associated with HPVG were bowel necrosis (43%), digestive tract dilatation (12%), intraperitoneal abscess (11%), ulcerative colitis (4%), gastric ulcer (4%), Crohn disease (4%), complications of endoscopic procedures (4%), intraperitoneal tumor (3%), and other (15%). The overall mortality was 39% but varied depending on the underlying disease.


CONCLUSIONS
Hepatic portal venous gas is a lethal or curable entity caused by various diseases. The underlying disease associated with HPVG determines the clinical features and prognosis of the patients. The treatment of patients with HPVG should be directed to the underlying disease.
Kinoshita
H
H
Critical Care Medical Center, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
Shinozaki
M
M
Tanimura
H
H
Umemoto
Y
Y
Sakaguchi
S
S
Takifuji
K
K
Kawasaki
S
S
Hayashi
H
H
Yamaue
H
H
D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications; D005260:Female; D005740:Gases; D006503:Hepatic Veins; D006801:Humans; D007422:Intestines / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis
D005740:Gases