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    International Journal of Innovative Science and Research Technology
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    Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. Hepatic portal venous gas when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention. We present a case of a 35 year-old male patient with a 12 hour history of generalised abdominal pain, watery diarrhoea and vomiting. He had a background of gout and alcoholism. He had an unmeasurable blood pressure and sinus tachycardia when he was first seen.

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    Hepatic Portovenous Gas in a Young Male

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    Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. Hepatic portal venous gas when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention. We present a case of a 35 year-old male patient with a 12 hour history of generalised abdominal pain, watery diarrhoea and vomiting. He had a background of gout and alcoholism. He had an unmeasurable blood pressure and sinus tachycardia when he was first seen.

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    6 views2 pages

    Hepatic Portovenous Gas in A Young Male

    Uploaded by

    International Journal of Innovative Science and Research Technology
    Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. Hepatic portal venous gas when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention. We present a case of a 35 year-old male patient with a 12 hour history of generalised abdominal pain, watery diarrhoea and vomiting. He had a background of gout and alcoholism. He had an unmeasurable blood pressure and sinus tachycardia when he was first seen.

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    Volume 9, Issue 4, April – 2024 International Journal of Innovative Science and Research Technology

    ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24APR764

    Hepatic Portovenous Gas in a Young Male


    T. Rama Rao*1; R. Srujana2; Rabia Basri2; J. Namratha2
    *1
    Professor and Principal, CMR College of Pharmacy, Hyderabad, Telangana, India
    2
    Department of Pharm. D, CMR College of Pharmacy, Hyderabad, Telangana, India

    Corresponding Author’s Address:


    Tadikonda Rama Rao
    Professor and Principal
    CMR College of Pharmacy,
    Kandlakoya(V), Medchal Road,
    Telangana -501401

    Abstract:- Hepatic portal venous gas is diagnosed via II. CASE STUDY
    computed tomography due to unusual imaging features.
    Hepatic portal venous gas when linked with pneumatosis A 35 year-old male patient came via ambulance to the
    intestinalis has a high mortality rate and required urgent emergency department with a 12 hour history of generalised
    intervention. We present a case of a 35 year-old male abdominal pain, watery diarrhoea and vomiting. He had a
    patient with a 12 hour history of generalised abdominal background of gout and alcoholism. The patient denied
    pain, watery diarrhoea and vomiting. He had a abusing drugs when questioned further. He had an
    background of gout and alcoholism. He had an unmeasurable blood pressure and sinus tachycardia when he
    unmeasurable blood pressure and sinus tachycardia was first seen. A physical examination found that his right
    when he was first seen. The patient was stabilized after side of the abdomen was stiff. With a lactate level of 15,
    undergoing vigorous intravenous fluid resuscitation, and venous blood gas analysis showed a severe anion gap
    he was then sent for a CT scan. A considerable amount metabolic acidosis; a complete blood count revealed
    of hepatic portovenous gas was seen on the CT scan, neutrophilia. Elevated lipase levels were observed along
    coupled with dilated and diffusely aberrant small and with abnormalities in liver function tests. The patient was
    large bowel with mucosal enhancement. stabilized after undergoing vigorous intravenous fluid
    resuscitation, and he was then sent for a CT scan. A
    Keywords:- Hepatic Portal Venous Gas, Enterocolitis, Small considerable amount of hepatic portovenous gas (HPVG)
    Bowel Obstruction, Subserosal, Submucosal. was seen on the CT scan, coupled with dilated and diffusely
    aberrant small and large bowel with mucosal enhancement.
    I. INTRODUCTION Significant stranding around the external iliac and common
    femoral arteries was also noted indicating diffuse bowel
    Hepatic portal venous gas (HPVG) is a medical illness ischemia. Sadly, the patient passed away before being
    that affects the portal venous system and its branches. moved from emergency room, despite the surgery team
    Clinical signs of HPVG might range from mild disorders to plans to perform an exploratory laparotomy. Without a
    serious illnesses[1]. HPVG was first reported as a finding in discernible underlying cause, a post-mortem investigation
    new-borns with necrotizing enterocolitis. Since then, it has demonstrated indications of acute small intestinal ischemia.
    been linked to a number of underlying abdominal ailments, One theory was that the reason could have been mechanical,
    ranging from benign conditions to potentially fatal like a tiny bowel volvulus that resolved on its own.
    conditions needing emergency surgery[2]. When HPVG is
    diagnosed, it might indicate a number of underlying clinical
    disorders, from benign etiologies to serious illnesses
    requiring emergency surgery[3].

    The diagnosis of HPVG implies various underlying


    clinical conditions, ranging from benign etiologiesto severe
    clinical conditions that need immediate surgical treatment.

    IJISRT24APR764 www.ijisrt.com 711


    Volume 9, Issue 4, April – 2024 International Journal of Innovative Science and Research Technology
    ISSN No:-2456-2165 https://doi.org/10.38124/ijisrt/IJISRT24APR764

    [2]. Mubarik, Ateeq MD1; Siddiqui, Salaah DO1; Iqbal,


    Arshad Muhammad MD1; Mohammed, Sohaib
    Khaleel MD2; Muddassir, Salman MD1; Eddib,
    Abdulmagid MD1; Herraka, Ihab MD3. Iatrogenic
    Hepatic portal venous gas in a patient with crohn's
    disease after colonoscopy. ACG Case Reports Journal
    6(8): p e00150, August 2019. | DOI:
    10.14309/crj.0000000000000150
    [3]. Kim HJ, Kim HK. Idiopathic hepatic portal venous gas
    in a healthy young man. Int J Gen Med. 2020;13:687‐
    692. doi: 10.2147/IJGM.S276438 [PMC free
    article] [PubMed] [CrossRef] [Google Scholar]
    [4]. Sisk PB. Gas in the portal venous system. Radiology
    1961;77(1):103–7. |Google Scholar
    [5]. Cunningham G, Cameron G, De Cruz P. Hepatic portal
    venous gas in Crohn's disease. BMJ Case Rep.
    2014;2014:bcr2014206244. |Google Scholar
    Fig 1: Plain Radiographs of the Chest (A) and Abdomen (B) [6]. Wang M, Song J, Gong S, Yu Y, Hu W, Wang
    Displaying Hepatic Portal Venous Gas (Arrow Head) and Y. Hepatic portal venous gas with pneumatosis
    Subphrenic Free Air (White Arrow). intestinalis secondary to mesenteric ischemia in elderly
    patients: two case reports. Medicine (Baltimore).
    III. DISCUSSION AND CONCLUSION 2020;99(17):e19810. doi:
    10.1097/MD.0000000000019810 [PMC free
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    ulcerative colitis (8%), intra-abdominal abscess (6%), small intestinalis and hepatic portal venous gas. J
    bowel obstruction (3%), and gastric ulcers (3%), are also Hepatobiliary Pancreat Surg. 2008;15(3):334‐337.
    frequently linked to HPVG. We are presenting HPVG as an doi: 10.1007/s00534-007-1246-1 [PubMed]
    uncommon but well-known Crohn's disease consequence, as [CrossRef] [Google Scholar]
    it is shown in the case. About 58% of HPVG cases linked to [8]. Liebman PR, Patten MT, Manny J, Benfield
    Crohn's disease are iatrogenic, meaning they resulted from JR, Hechtman HB. Hepatic-portal venous gas in adults:
    blunt abdominal trauma, barium enema studies, or Etiology, pathophysiology and clinical
    colonoscopies[4, 5]. Three potential mechanisms of HPVG are significance. Annals of Surgery 1978; 187: 281–7.
    mucosal injury, intestinal distension, and sepsis brought on [9]. Vleggaar FP, van Buuren HR, Schalm SW. Endoscopic
    by gas-forming bacteria. Of the patients with hepatic portal sclerotherapy for bleeding esophagogastric varices
    venous gas, over two-thirds had a necrotic gut. Gas-filled secondary to extrahepatic portal venous obstruction in
    subserosal and submucosal cysts in the digestive system, an adult population. Eur J Gastroenterol Heptaol
    known as pneumatosis intestinalis (PI), are often 1998;10:81–5.
    accompanied with gas in the hepatic portal vein [6, 7]. Simple
    abdominal X-rays can show branching radiolucencies that
    extend to within 2 cm of the hepatic capsule, which is
    indicative of hepatic PVG. They are most useful in revealing
    PVG when the patient is in the left lateral decubitus posture
    [8]
    . Treatment for varices secondary to PVT involves
    endoscopic elimination with VBL, beta-blockers, and
    nitrates, and is comparable to methods for varices from other
    portal hypertension mechanisms. According to one study,
    these procedures are very effective and low risk; it shows a
    95% 5-year survival rate and no mortality from recurrent
    bleeding in cases of extrahepatic portal vein obstruction. [9]

    REFERENCES

    [1]. Dhakal P, Sharma S, Sharma A, Pandey S, Aryal S,


    Bhnadari S. Hepatic portal venous gas in the case of
    superior mesenteric artery thrombosis in a young adult-
    case report. Clin Case Rep. 2023 Feb 24;11(2):e6989.
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    PMC9957697.

    IJISRT24APR764 www.ijisrt.com 712

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