Hong J J, Gadaleta D, Rossi P, Esquivel J, Davis J M
Department of Surgery, New York Hospital-Cornell Medical Center, New York, USA.
Arch Surg. 1997 Oct;132(10):1071-5. doi: 10.1001/archsurg.1997.01430340025003.
To assess the clinical significance of portal vein gas (PVG) demonstrated by computed tomography (CT).
Review of medical records.
Three network-affiliated hospitals providing both primary community-based and tertiary services.
Review of diagnosis, clinical circumstances, and significance of PVG in 7 patients detected by CT during a 3-year period in 3 affiliated hospitals.
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.
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.
