Hepatic Portal Venous Gas

Authors

Joris M. Franken Department of Surgery, Amphia Hospital, Breda, The Netherlands A 64-year old patient was admitted to our hospital with acute abdominal pain. Physical examination showed tenderness in the lower right abdominal quadrant. Initial laboratory tests revealed no significant abnormalities. Abdominal CT demonstrated lucencies in the vena portae and peripheries of the liver (Fig. 1). Laparoscopy showed a normal aspect of the intra-abdominal organs. The patient was conservatively treated with antibiotics and a postoperative colonoscopy showed an ischemic colitis of the right hemicolon. A right hemicolectomy was performed and pathological examination revealed an ulcerative aspect of the colon in accordance with ischemia. Two weeks later the patient was discharged in a good overall condition. In the outpatient setting a new colonoscopy was performed, with no pathology seen. The patient was at that moment free of complaints. Air in the portal venous system is a relatively rare but ominous sign,
Eelco J. Veen Department of Surgery, Amphia Hospital, Breda, The Netherlands

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