Moser, AlexandreAlexandreMoserStauffer, AnitaAnitaStaufferWyss, AndréAndréWyssSchneider, ClaudioClaudioSchneiderEssig, ManfredManfredEssigRadke, AlexanderAlexanderRadke2024-10-242024-10-242016https://boris-portal.unibe.ch/handle/20.500.12422/149282INTRODUCTION 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.enCase reportHepatic portal venous gas (HPVG)PneumoportogramSigmoid diverticulitis600 - Technology::610 - Medicine & healtharticle10.7892/boris.946722718022910.1016/j.ijscr.2016.04.042