Computed tomographic evidence of hepatic portal venous gas after blunt abdominal trauma does not necessitate surgery.
Historically, hepatic portal venous gas (HPVG) seen on abdominal radiographic examination indicated serious intra-abdominal pathology requiring urgent operative intervention. The mortality attributed to HPVG is associated closely with its causative source rather than a direct effect of the presence of venous air and, therefore, the finding should be correlated with a careful clinical examination before any therapeutic endeavor. Fourteen cases of HPVG associated with blunt trauma have been reported over the past 20 years, and only half of these have resulted in surgery. We report the case of a 24-year-old woman who presented with no abdominal pathology other than HPVG after a severe motor vehicle crash. She was managed nonoperatively and made a successful recovery.
Vercruysse
Gary A
GA
Department of Surgery, Emory University, Atlanta, Georgia 30303, USA. Gary.vercruysse@emory.org
Adams
Sasha D
SD
Feliciano
David V
DV
D000007:Abdominal Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D000328:Adult; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D005260:Female; D006503:Hepatic Veins; D006801:Humans; D011169:Portal Vein; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery