Ann Res Rev | Volume 1, Issue 1 | Case Report | Open Access

A Rare Case of Hepatic Portal Venous Gas and Its Management in the Emergency Department Discussed in Light of the Current Literature

Yeniocak Selman1*, Yılmaz Behice Kaniye2, Az Adem1, Demirel Ahmet3, Özden Muhammed Furkan1 and Akdemir Tarık1

1Department of Emergency, University of Health Sciences, Haseki Training and Research Hospital, Turkey
2Department of Radiology, University of Health Sciences, Haseki Training and Research Hospital, Turkey
3Department of Emergency, University of Health Sciences, Okmeydani Training and Research Hospital, Turkey

*Correspondance to: Yeniocak Selman 

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Abstract

Hepatic Portal Venous Gas (HPVG) is a rare condition. It is not a specific disease, but a diagnostic radiological finding in patients with underlying acute abdominal pathology. This report is intended to discuss, in the light of the current literature, a patient brought to the emergency department due to impaired consciousness and in whom rare HPVG was determined. An 83-year-old woman was brought to the emergency department due to impaired consciousness. The patient was bedridden, and nutrition had been provided by means of Percutaneous Endoscopic Gastrostomy (PEG) for the previous two years due to functional swallowing disorder. At physical examination, the abdomen was distended, and bowel sounds were hypoactive. Formed stool was observed at rectal examination. Non-specific gas shadows were present at abdominal X-ray. Abdominal USG could not be effectively evaluated due to diffuse gas artifacts. Abdominal Computerized Tomography (CT) revealed HPVG, perihepatic free fluid collection, and intra-abdominal free air values in the walls of the splenic flexure, in the splenic vein and the superior mesenteric vein, and around the splenic flexure. These findings were interpreted in favor of intestinal ischemia. The general surgery department was consulted, and the patient was taken for emergency surgery. We think that Multiple Detector CT (MDCT) angiography, a diagnostic radiological imaging technique, is the gold standard for the immediate detection of life-threatening primary pathologies in patients with confirmed or suspected HPVG, for prompt transferal of these to the operating room for emergency intervention and for increasing minimization of mortality rates.

Citation:

Yeniocak S, Kaniye YB, Adem A, Ahmet D, Muhammed Furkan Ö, Tarık A. A Rare Case of Hepatic Portal Venous Gas and Its Management in the Emergency Department Discussed in Light of the Current Literature. Ann Res Rev. 2020;1(1):1001..

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