Conservative treatment of hepatic portal venous gas consecutive to a complicated diverticulitis: A case report and literature review.
Publisher DOI
PubMed ID
27180229
Abstract
INTRODUCTION AND PRESENTATION OF CASE
Eight days after being diagnosed with multiple small strokes a 71year old male patient is readmitted with suspicion of a petit mal seizure also complained of diarrhoea and abdominal pain. The patient was stable, not febrile and neurologically intact with a slight tenderness in the left lower quadrant. An ultrasound revealed presence of air in the hepatic portal venous system and a suspicion for sigmoid diverticulitis. A CT-scan confirmed both diagnoses. We proceeded with a conservative regimen under close observation. The clinical course and laboratory results were unremarkable.
DISCUSSION
The review of the literature (PubMed database) triggered 685 items with only one clinical trial establishing a scoring system to detect adult individuals, which need operation.
CONCLUSION
A pneumoportogram (hepatic portal venous gas, HPVG) is a very rare and usually associated with bowel ischemia and from poor prognosis. The last decades saw the emergence of numerous other aetiologies (also benign) with a shift of paradigm from systematic emergency laparotomies to individual patient selection.
Eight days after being diagnosed with multiple small strokes a 71year old male patient is readmitted with suspicion of a petit mal seizure also complained of diarrhoea and abdominal pain. The patient was stable, not febrile and neurologically intact with a slight tenderness in the left lower quadrant. An ultrasound revealed presence of air in the hepatic portal venous system and a suspicion for sigmoid diverticulitis. A CT-scan confirmed both diagnoses. We proceeded with a conservative regimen under close observation. The clinical course and laboratory results were unremarkable.
DISCUSSION
The review of the literature (PubMed database) triggered 685 items with only one clinical trial establishing a scoring system to detect adult individuals, which need operation.
CONCLUSION
A pneumoportogram (hepatic portal venous gas, HPVG) is a very rare and usually associated with bowel ischemia and from poor prognosis. The last decades saw the emergence of numerous other aetiologies (also benign) with a shift of paradigm from systematic emergency laparotomies to individual patient selection.
Date Issued
2016
Publication Type
Article
Subject(s)
Subjects
Case report
•
Hepatic portal venous gas (HPVG)
•
Pneumoportogram
•
Sigmoid diverticulitis
Language(s)
en
Author(s)
Moser, Alexandre | |
Stauffer, Anita | |
Wyss, André | |
Essig, Manfred | |
Radke, Alexander |
Additional Credits
Journal
International journal of surgery case reports
Publisher
Elsevier
ISSN
2210-2612
Access(Rights)
open.access