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Emergency Radiology

, Volume 12, Issue 4, pp 164–170 | Cite as

Detection of hepatic portal venous gas: its clinical impact and outcome

  • Sebastian T. Schindera
  • Juergen Triller
  • Peter Vock
  • Hanno HoppeEmail author
Original Article

Abstract

The clinical impact and outcome of a rare radiographic finding of hepatic portal venous gas (HPVG) as well as the effectiveness of computed tomography (CT), CT scanogram, and conventional radiography in the detection of HPVG were retrospectively analyzed. CT scans, CT scanogram, and plain film radiographs of 11 patients with HPVG were reviewed and compared with their medical records and surgical and pathology reports. Eight of the 11 patients underwent plain film radiographs 1 day before or after the CT scan. HPVG was detected at CT in all 11 patients, on CT scanogram in three (3 of 11, 27.3%), and on plain films in one (one of eight, 12.5%). In nine of 11 patients (81.8%), CT revealed an associated pneumatosis intestinalis. In six of the 11 patients (54.6%), acute mesenteric ischemia was the underlying disease for HPVG. Seven patients (63.6%) underwent emergency exploratory laparotomy. The mortality rate for HPVG alone was 27.3% (3 of 11) and for HPVG related to mesenteric bowel disease 50% (three of six). Acute mesenteric ischemia is the most common cause of HPVG, which continues to have a predictably higher mortality. CT is superior to CT scanograms and radiographs in the detection of HPVG and its underlying diseases and, therefore, should be used as the primary diagnostic tool.

Keywords

Computed tomography Portal venous gas Mesenteric infarction 

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Copyright information

© Am Soc Emergency Radiol 2006

Authors and Affiliations

  • Sebastian T. Schindera
    • 1
  • Juergen Triller
    • 1
  • Peter Vock
    • 1
  • Hanno Hoppe
    • 1
    Email author
  1. 1.Department of Diagnostic RadiologyUniversity Hospital of Bern, InselspitalBernSwitzerland

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