Hepatic portal venous gas associated with ischemic colitis: a case report
Dublin Core
Title
Hepatic portal venous gas associated with ischemic colitis: a case report
Subject
Hepatic portal venous gas, Colon ulcers, Case reports
Description
Abstract
Background Cases of Hepatic portal venous gas (HPVG) have been associated with high mortality rates and
frequently require emergency exploratory laparotomy. However, the widespread utilization of computed tomography
(CT) scans has revealed that HPVG is often connected to benign conditions, as demonstrated by numerous studies.
Given the intricate nature of the underlying causes of HPVG, there remains a lack of consensus regarding the necessity
of emergency surgical exploration for patients with HPVG.
Case Report An octogenarian female patient was admitted to the emergency department due to abdominal pain,
accompanied by symptoms of nausea and vomiting. A CT scan of the abdomen and pelvis revealed a significant
presence of radiolucency in the peripheral branching of the liver, indicating the existence of portal venous
gas. Subsequently, the patient was transferred to the Emergency Intensive Care Unit for further management.
Colonoscopy of the patient reveals features consistent with ischemic colitis, characterized by mucosal congestion,
edema, erosion, ulcers, with some ulcers covered by pseudomembranes. After undergoing a series of conservative
treatments, the patient’s condition improved, as confirmed by a follow-up CT scan of the abdomen and pelvis
conducted 8 days later, which showed complete absorption of the gas. Consequently, the patient was discharged
from the hospital.
Conclusions The management of HPVG should take into account the pathophysiology and clinical manifestation,
and should be tailored towards addressing the root cause. The selection of surgical or conservative intervention
should be guided by the underlying etiology, while the prognosis and outcome of HPVG are contingent upon the
underlying cause.
Keywords Hepatic portal venous gas, Colon ulcers, Case reports
Background Cases of Hepatic portal venous gas (HPVG) have been associated with high mortality rates and
frequently require emergency exploratory laparotomy. However, the widespread utilization of computed tomography
(CT) scans has revealed that HPVG is often connected to benign conditions, as demonstrated by numerous studies.
Given the intricate nature of the underlying causes of HPVG, there remains a lack of consensus regarding the necessity
of emergency surgical exploration for patients with HPVG.
Case Report An octogenarian female patient was admitted to the emergency department due to abdominal pain,
accompanied by symptoms of nausea and vomiting. A CT scan of the abdomen and pelvis revealed a significant
presence of radiolucency in the peripheral branching of the liver, indicating the existence of portal venous
gas. Subsequently, the patient was transferred to the Emergency Intensive Care Unit for further management.
Colonoscopy of the patient reveals features consistent with ischemic colitis, characterized by mucosal congestion,
edema, erosion, ulcers, with some ulcers covered by pseudomembranes. After undergoing a series of conservative
treatments, the patient’s condition improved, as confirmed by a follow-up CT scan of the abdomen and pelvis
conducted 8 days later, which showed complete absorption of the gas. Consequently, the patient was discharged
from the hospital.
Conclusions The management of HPVG should take into account the pathophysiology and clinical manifestation,
and should be tailored towards addressing the root cause. The selection of surgical or conservative intervention
should be guided by the underlying etiology, while the prognosis and outcome of HPVG are contingent upon the
underlying cause.
Keywords Hepatic portal venous gas, Colon ulcers, Case reports
Creator
Lian Lin1
, Qianqian Zhou1
, Junlong Gao1
and Hong Zhang1*
, Qianqian Zhou1
, Junlong Gao1
and Hong Zhang1*
Source
https://doi.org/10.1186/s12245-025-00837-z
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Lian Lin1
, Qianqian Zhou1
, Junlong Gao1
and Hong Zhang1*, “Hepatic portal venous gas associated with ischemic colitis: a case report,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12671.