title: Conservative approach to Hepatic Portal Venous Gas: A case report.
abstract: BACKGROUND
  Hepatic Portal Venous Gas (HPVG), a rare condition in which gas accumulates in the portal venous circulation, is often associated with a significant underlying pathology, such as Crohn's disease, ulcerative colitis, diverticulitis, pancreatitis, sepsis, intra-abdominal abscess, endoscopic procedures, mesenteric ischemia, abdominal trauma.
  
  
  METHODS
  Here we report a case of HPVG in an 82-year-old patient who underwent a left colectomy for stenosing tumor of the descending colon. The patient was treated conservatively, and his symptoms resolved. Follow-up computed tomography (CT) scan showed complete resolution of HPVG.
  
  
  CONCLUSIONS
  The mechanism underlying the passage of the gas from the intestine into the mesenteric, then portal, venous system is not fully understood. Historically, this condition has been related to acute intestinal ischemia, as a consequence of a bacterial translocation through a wall defect.
  
  
  CONCLUSIONS
  This case underscores the role of conservative management, highlighting how the severity of the prognosis of HPVG should be related to the underlying pathology, and not influenced by the presence of HPVG itself.
authors.affiliation: Unit of General Surgery 2, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Electronic address: ginesugc@uniss.it.
authors.forename: G C
authors.initials: GC
authors.lastname: Ginesu
authors.affiliation: Unit of General Surgery 2, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Electronic address: michelebarmina@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Barmina
authors.affiliation: Unit of General Surgery 2, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Electronic address: mlcossu@uniss.it.
authors.forename: M L
authors.initials: ML
authors.lastname: Cossu
authors.affiliation: Unit of General Surgery 2, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Electronic address: cffeo@uniss.it.
authors.forename: C F
authors.initials: CF
authors.lastname: Feo
authors.affiliation: Unit of General Surgery 2, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Electronic address: afancel@uniss.it.
authors.forename: A
authors.initials: A
authors.lastname: Fancellu
authors.affiliation: Unit of General Surgery 2, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Electronic address: fra.addis49@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Addis
authors.affiliation: Unit of General Surgery 2, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy. Electronic address: alb.porcu@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Porcu
keywords: Bowel obstruction; Complications abdominal surgery; Computed tomography; Mesenteric ischemia; Portal venous gas