title: Conservative treatment of hepatic portal venous gas consecutive to a complicated diverticulitis: A case report and literature review.
abstract: Eight days after being diagnosed with multiple small strokes a 71year old male patient is readmitted with suspicion of a petit mal seizure also complained of diarrhoea and abdominal pain. The patient was stable, not febrile and neurologically intact with a slight tenderness in the left lower quadrant. An ultrasound revealed presence of air in the hepatic portal venous system and a suspicion for sigmoid diverticulitis. A CT-scan confirmed both diagnoses. We proceeded with a conservative regimen under close observation. The clinical course and laboratory results were unremarkable.
  
  
  CONCLUSIONS
  The review of the literature (PubMed database) triggered 685 items with only one clinical trial establishing a scoring system to detect adult individuals, which need operation.
  
  
  CONCLUSIONS
  A pneumoportogram (hepatic portal venous gas, HPVG) is a very rare and usually associated with bowel ischemia and from poor prognosis. The last decades saw the emergence of numerous other aetiologies (also benign) with a shift of paradigm from systematic emergency laparotomies to individual patient selection.
authors.affiliation: Department of Internal Medicine, Hospital of Zweisimmen, Switzerland. Electronic address: alexandre.moser@ssvnn.net.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Moser
authors.affiliation: Department of Internal Medicine, Hospital of Zweisimmen, Switzerland.
authors.forename: Anita
authors.initials: A
authors.lastname: Stauffer
authors.affiliation: Department of Radiology, Hospital of Thun, Switzerland.
authors.forename: André
authors.initials: A
authors.lastname: Wyss
authors.affiliation: University Clinic for General Internal Medicine, University Hospital of Bern, Switzerland.
authors.forename: Claudio
authors.initials: C
authors.lastname: Schneider
authors.affiliation: Department of Internal Medicine, Hospital of Zweisimmen, Switzerland.
authors.forename: Manfred
authors.initials: M
authors.lastname: Essig
authors.affiliation: Department of Surgery, Hospital of Zweisimmen, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Radke
keywords: Case report; Hepatic portal venous gas (HPVG); Pneumoportogram; Sigmoid diverticulitis