OBJECTIVE: To assess the clinical significance of portal vein gas (PVG) demonstrated by computed tomography (CT). DESIGN: Review of medical records. SETTING: Three network-affiliated hospitals providing both primary community-based and tertiary services. METHODS: Review of diagnosis, clinical circumstances, and significance of PVG in 7 patients detected by CT during a 3-year period in 3 affiliated hospitals. RESULTS: Four of 7 patients underwent laparotomy; 1 patient refused surgery. Two patients were treated with intravenous antibiotics only and had uneventful clinical courses. Of the 3 patients who died, 1 refused and 2 underwent laparotomy. CONCLUSIONS: This series indicates that more sensitive imaging and more widespread use of endoscopic retrograde cholangiopancreatography, colonoscopy, and liver transplantation have changed the clinical presentation of PVG; PVG may be found in various clinical settings that do not mandate laparotomy; and the significance of PVG must be derived from the clinical context of the individual patient.
OBJECTIVE: To assess the clinical significance of portal vein gas (PVG) demonstrated by computed tomography (CT). DESIGN: Review of medical records. SETTING: Three network-affiliated hospitals providing both primary community-based and tertiary services. METHODS: Review of diagnosis, clinical circumstances, and significance of PVG in 7 patients detected by CT during a 3-year period in 3 affiliated hospitals. RESULTS: Four of 7 patients underwent laparotomy; 1 patient refused surgery. Two patients were treated with intravenous antibiotics only and had uneventful clinical courses. Of the 3 patients who died, 1 refused and 2 underwent laparotomy. CONCLUSIONS: This series indicates that more sensitive imaging and more widespread use of endoscopic retrograde cholangiopancreatography, colonoscopy, and liver transplantation have changed the clinical presentation of PVG; PVG may be found in various clinical settings that do not mandate laparotomy; and the significance of PVG must be derived from the clinical context of the individual patient.
Authors: Franz Sellner; Babak Sobhian; Martina Baur; Stephanie Sellner; Barbara Horvath; Margit Mostegel; Josef Karner; Stefan Staettner Journal: Int J Colorectal Dis Date: 2007-07-19 Impact factor: 2.571