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European Radiology

, Volume 12, Issue 6, pp 1432–1437 | Cite as

Portal-venous gas unrelated to mesenteric ischemia

  • Walter Wiesner
  • Koenraad J. Mortelé
  • Jonathan N. Glickman
  • Hoon Ji
  • Pablo R. Ros
Hepatobiliary–Pancreas

Abstract.

The aim of this study was to report on 8 patients with all different non-ischemic etiologies for portal-venous gas and to discuss this rare entity and its potentially misleading CT findings in context with a review of the literature. The CT examinations of eight patients who presented with intrahepatic portal-venous gas, unrelated to bowel ischemia or infarction, were reviewed and compared with their medical records with special emphasis on the pathogenesis and clinical impact of portal-venous gas caused by non-ischemic conditions. The etiologies for portal-venous gas included: abdominal trauma (n=1); large gastric cancer (n=1); prior gastroscopic biopsy (n=1); prior hemicolectomy (n=1); graft-vs-host reaction (n=1); large paracolic abscess (n=1); mesenteric recurrence of ovarian cancer superinfected with clostridium septicum (n=1); and sepsis with Pseudomonas aeruginosa (n=1). The clinical outcome of all patients was determined by their underlying disease and not negatively influenced by the presence of portal-venous gas. Although the presence of portal-venous gas usually raises the suspicion of bowel ischemia and/or intestinal necrosis, this CT finding may be related to a variety of non-ischemic etiologies and pathogeneses as well. The knowledge about these conditions may help to avoid misinterpretation of CT findings, inappropriate clinical uncertainty and unnecessary surgery in certain cases.

Computed tomography Portal-venous gas Portal-venous air Intrahepatic gas 

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Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • Walter Wiesner
    • 1
  • Koenraad J. Mortelé
    • 1
  • Jonathan N. Glickman
    • 2
  • Hoon Ji
    • 1
  • Pablo R. Ros
    • 1
  1. 1.Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USAUSA
  2. 2.Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USAUSA

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