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Surgery Today

, Volume 32, Issue 7, pp 655–658 | Cite as

Hepatic Portal Venous Gas Caused by Blunt Abdominal Trauma: Is It a True Ominous Sign of Bowel Necrosis?: Report of a Case

  • Yoshitaka Furuya
  • Hiroshi Yasuhara
  • Kaori Ariki
  • Hironobu Yanagie
  • Shuji Naka
  • Tohru Nojiri
  • Hiroki Shinkawa
  • Hiroki Niwa
  • Toshitaka Nagao

Abstract.

A case of transient portal venous gas in the liver following blunt abdominal trauma is described. Computed tomography (CT) demonstrated hepatic portal venous gas 4 h after the injury. An exploratory laparotomy revealed segmental necrosis of the small intestine with a rupture of the bladder. Pneumatosis intestinalis was evident on the resected bowel. A histopathologic study revealed congestion and bleeding in the bowel wall and a great deal of the mucosa had been lost because of necrosis. However, neither thrombus nor atherosclerotic changes were observed in the vessels. A bacteriological examination demonstrated anaerobic bacteria from the bowel mucosa, which was most likely to produce portal venous gas. Although the present case was associated with bowel necrosis, a review of literature demonstrated that portal venous gas does not necessarily indicate bowel necrosis in trauma patients. There is another possibility that the portal venous gas was caused by a sudden increase in the intra-abdominal pressure with concomitant mucosal disruption, which thus forced intraluminal gas into the portal circulation in the blunt trauma patients.

Key words Portal venous gas Trauma Necrosis Small intestine 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Yoshitaka Furuya
    • 1
  • Hiroshi Yasuhara
    • 1
  • Kaori Ariki
    • 1
  • Hironobu Yanagie
    • 1
  • Shuji Naka
    • 1
  • Tohru Nojiri
    • 1
  • Hiroki Shinkawa
    • 1
  • Hiroki Niwa
    • 1
  • Toshitaka Nagao
    • 2
  1. 1.Departments of Surgery andJP
  2. 2.Pathology, Teikyo University School of Medicine, Ichihara Hospital, 3426-3 Anegasaki, Ichihara, Chiba 299-0111, JapanJP

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