[Is hepatic portal venous gas the writing on the wall?].
BACKGROUND
Hepatic portal venous gas, which may occur in conjunction with severe intra-abdominal infections, is associated with a high mortality rate and is considered as an alarm signal.


METHODS
CT diagnostics revealed hepatic portal venous gas in a 65-year-old patient with advanced perforated sigmoid diverticulitis. This phenomenon was also observed in a 75-year-old patient in association with an upside-down stomach incarceration. Both patients underwent emergency surgery and survived this life-threatening disease.


CONCLUSIONS
Since hepatic portal gas is usually caused by severe intra-abdominal diseases with a high mortality rate, this warning sign should, at the latest, result in urgent laparotomy, if the indication has not already been established for other reasons.
Nicolaus
T
T
Chirurgische Klinik I, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin.
Buhr
H J
HJ
Kruschewski
M
M
D018784:Abdominal Abscess / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D000368:Aged; D004239:Diverticulitis, Colonic / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D004618:Embolism, Air / Q000000981:diagnostic imaging*; D005743:Gastrectomy; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D008100:Liver Abscess / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D008297:Male; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D013277:Stomach Volvulus / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D013290:Streptococcal Infections / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D013291:Streptococcus; D015996:Survival Rate; D036542:Tomography, Spiral Computed