José-Luis Martínez1, Jorge González-Acosta. 1. Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades CMN Siglo XXI (IMSS), México City, México. jlmo1968@yahoo.com
Abstract
UNLABELLED: When portal venous gas (PVG) is found, it is usually considered an ominous sign. It is now more frequently found because of the improvement in imaging studies, mainly through computed tomography (CT). It was first related primarily to mesenteric ischemia. However, it is now identified in other conditions and the prognosis is not related to the presence in itself of PVG, but to the nature and severity of the underlying condition or disease that causes it. Next, we report three patients with portal venous gas that were seen at our surgical department. All the patients presented acute abdominal pain and during their diagnostic studies, portal venous gas was identified. Intestinal ischemia was diagnosed in two of them, who underwent an exploratory laparotomy, one of them died within 24 hours. In the other patient, the pain subsided and was treated medically and the recovery was uneventful. IN CONCLUSION: the most important factor related to portal venous gas is the disease that caused it. The most common cause of PVG is mesenteric ischemia, so every effort should be made to rule it out, as the prognosis is related to an early diagnosis and almost all patients require surgery. Other causes had been reported and conservative treatment could be used in selected cases.
UNLABELLED: When portal venous gas (PVG) is found, it is usually considered an ominous sign. It is now more frequently found because of the improvement in imaging studies, mainly through computed tomography (CT). It was first related primarily to mesenteric ischemia. However, it is now identified in other conditions and the prognosis is not related to the presence in itself of PVG, but to the nature and severity of the underlying condition or disease that causes it. Next, we report three patients with portal venous gas that were seen at our surgical department. All the patients presented acute abdominal pain and during their diagnostic studies, portal venous gas was identified. Intestinal ischemia was diagnosed in two of them, who underwent an exploratory laparotomy, one of them died within 24 hours. In the other patient, the pain subsided and was treated medically and the recovery was uneventful. IN CONCLUSION: the most important factor related to portal venous gas is the disease that caused it. The most common cause of PVG is mesenteric ischemia, so every effort should be made to rule it out, as the prognosis is related to an early diagnosis and almost all patients require surgery. Other causes had been reported and conservative treatment could be used in selected cases.