Hepatic portal venous gas. Imaging modalities and clinical significance.

In a prospective investigation the sensitivity of conventional radiography, sonography, color Doppler flow imaging (CDFI) and CT in the detection of hepatic portal venous gas (HPVG) was compared in 7 patients with different diagnoses. For the identification of HPVG sonography, CDFI and CT have a higher sensitivity than conventional radiography. CT, however, was the most suitable method to identify the underlying cause of HPVG. Patients with iatrogenic HPVG as a result of diagnostic or therapeutic intervention had a good prognosis. In contrast, in all cases with a sudden appearance of HPVG and a noniatrogenic cause, exitus ensued within 1 week.