Portal venous gas - benign etiology

Discussion:

The patient went on the theater, where exploratory laparoscopy was performed. All intestinal segments were vital. The patient was diagnosed with severe gastroenteritis both clinically and by stool analysis.

Hepatic portal venous gas, when seen on conventional x-rays, is often associated with a poor prognosis. However, with the advent of cross-sectional imagining, the detection of hepatic portal venous gas has improved and several benign causes have been reported in literature 1-2,4

Although a repeat imaging study in stable patients has been proposed, most authors suggest exploratory laparotomy 3 as the standard of care when dealing with symptomatic patients, in order to rule out sinister pathology such as mesenteric ischemia. 

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