Editorial
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 7, 2009; 15(29): 3585-3590
Published online Aug 7, 2009. doi: 10.3748/wjg.15.3585
Hepatic portal venous gas: Physiopathology, etiology, prognosis and treatment
Bassam Abboud, Jad El Hachem, Thierry Yazbeck, Corinne Doumit
Bassam Abboud, Jad El Hachem, Thierry Yazbeck, Corinne Doumit, Department of General Surgery, Hotel-Dieu de France Hospital, Boulevard Alfred Naccache, Beirut 16-6830, Lebanon
Author contributions: Abboud B designed the research; Abboud B, El Hachem J and Doumit C performed the research; Abboud B, El Hachem J and Yazbeck T wrote the paper.
Correspondence to: Bassam Abboud, MD, Department of General Surgery, Hotel-Dieu de France Hospital, Alfred Naccache Street, Beirut 16-6830, Lebanon. dbabboud@yahoo.fr
Telephone: +961-1-615400
Fax: +961-1-615295
Received: May 9, 2009
Revised: July 7, 2009
Accepted: July 14, 2009
Published online: August 7, 2009
Abstract

Hepatic portal venous gas (HPVG), an ominous radiologic sign, is associated in some cases with a severe underlying abdominal disease requiring urgent operative intervention. HPVG has been reported with increasing frequency in medical literature and usually accompanies severe or lethal conditions. The diagnosis of HPVG is usually made by plain abdominal radiography, sonography, color Doppler flow imaging or computed tomography (CT) scan. Currently, the increased use of CT scan and ultrasound in the inpatient setting allows early and highly sensitive detection of such severe illnesses and also the recognition of an increasing number of benign and non-life threatening causes of HPVG. HPVG is not by itself a surgical indication and the treatment depends mainly on the underlying disease. The prognosis is related to the pathology itself and is not influenced by the presence of HPVG. Based on a review of the literature, we discuss in this paper the pathophysiology, risk factors, radiographic findings, management, and prognosis of pathologies associated with HPVG.

Keywords: Hepatic portal venous gas, Bowel ischemia/necrosis, Diverticulitis, Gastric pathologies, Ulcerative colitis, Abdominal computed tomography scan, Crohn’s disease, Liver transplantation, Chemotherapy