Portal vein gas, a changing clinical entity. Report of 7 patients and review of the literature

Arch Surg. 1997 Oct;132(10):1071-5. doi: 10.1001/archsurg.1997.01430340025003.


Objective: To assess the clinical significance of portal vein gas (PVG) demonstrated by computed tomography (CT).

Design: Review of medical records.

Setting: Three network-affiliated hospitals providing both primary community-based and tertiary services.

Methods: Review of diagnosis, clinical circumstances, and significance of PVG in 7 patients detected by CT during a 3-year period in 3 affiliated hospitals.

Results: Four of 7 patients underwent laparotomy; 1 patient refused surgery. Two patients were treated with intravenous antibiotics only and had uneventful clinical courses. Of the 3 patients who died, 1 refused and 2 underwent laparotomy.

Conclusions: This series indicates that more sensitive imaging and more widespread use of endoscopic retrograde cholangiopancreatography, colonoscopy, and liver transplantation have changed the clinical presentation of PVG; PVG may be found in various clinical settings that do not mandate laparotomy; and the significance of PVG must be derived from the clinical context of the individual patient.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Embolism, Air* / diagnostic imaging
  • Embolism, Air* / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Portal Vein* / diagnostic imaging
  • Tomography, X-Ray Computed