Optimal treatment strategies for hepatic portal venous gas: A retrospective assessment

Table 1 Preoperative findings, outcomes and final diagnosis of the surgical cases (n = 8)

Case	Age	Gender	Final diagnosis	Outcome	Chief complaints	Shock1	Peritoneal irritation signs	Ascites2	Intestinal pneumatosis	LOCE in intestinal wall	Free air	WBC (μL)	CRP (mg/dL)	BE (mmol/L)	Lactate (mg/dL)
13	72	F	NOMI	Recovery	Abdominal pain, nausea	+	+	2+	-	+	-	26000	1.57	-4.9	18
2	74	M	Clostridium enteritis	Recovery	Nausea, vomiting	-	+	2+	-	+	-	15400	16	5.3	7
3	65	F	NOMI	Recovery	Abdominal pain	-	-	-	-	+	+	31500	7.39	-7	13
4	86	M	Gastric perforation	Death	Abdominal pain, vomiting	+	+	3+	+	+	+	7800	0.17	-11.3	73
5	69	M	NOMI	Recovery	Abdominal pain	+	+	2+	+	-	-	13200	10.8	2.3	14
6	71	M	Mesenteric artery thrombosis	Recovery	Abdominal pain, vomiting	+	+	1+	+	+	+	22500	1.81	-6.3	46
7	84	M	NOMI	Recovery	Abdominal fullness	+	+	2+	+	NE	-	36700	15.54	-5.5	47
8	34	M	Strangulation ileus	Recovery	Abdominal fullness	-	NE	-	+	+	-	10000	4.67	-3.1	42

¹≤ Systolic blood pressure 90 mmHg.

²Semiquantitative evaluation as – (none).

³Shown as case 1 in the case presentation. 1+: Small amount; 2+: Moderate amount; 3+: Large amount. LOCE: Lack of contrast enhancement; BE: Base excess; NE: Not examined; NOMI: Non-occlusive mesenteric ischemia.

Table 2 Clinical data comparison between the non-surgical recovery and the non-surgical death cases

	Recovery (n = 16)	Death (n = 10)	P value
Age [median (range)]	86 (56-92)	84 (72-99)	P > 0.9991
Gender (M:F)	4:12	4:6	P = 0.6652
Shock (≤ systolic BP 90 mmHg) (%)	0 (0%)	6 (60%)	P = 0.0012
Peritoneal irritation (%)	2 (13%)	8 (80%)	P = 0.0012
Ascites (%)	5 (31%)	8 (80%)	P = 0.0412
Intestinal pneumatosis (%)	8 (50%)	7 (70%)	P = 0.4282
WBC (/μL) [median (range)]	9050 (4200-31800)	13400 (9900-19000)	P = 0.0251
CRP (mg/dL) [median (range)]	2.39 (0.11-28.41)	12.84 (0.1-33.26)	P = 0.3551
BE (mmol/L) [median (range)]	1.8 (-8.4 – 14.6)	-6.2 (-18.2 – 6.8)	P = 0.0711
Lactate (mg/dL) [median (range)]	26 (9-63)	36 (11-120)	P = 0.2311

¹Mann-Whitney-U test.

²Fisher’s exact test. A significant P value is shown on underline. BE: Base excess.

Table 3 Mortality prediction in the 26 non-surgical cases by the three factors [Ascites, peritoneal irritation sign (muscular defense and/or rebound tenderness), and shock]

	Recovery	Death
0-1 Factor	16	1
2-3 Factors	0	9