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January 2010

Careful Approach to the ABCs of the Management of Portal Venous Gas

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Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Surg. 2010;145(1):103-104. doi:10.1001/archsurg.2009.233

Nelson et al1 mentioned 182 cases of hepatic portal venous gas (HPVG) documented in the literature by 2001. Between 1975 and 2008, 275 were documented in the literature.2 Most were reported after the development of computed tomography (CT) owing to the decreased sensitivity of plain radiography (12.5%).3 Most of the studies support the idea that bowel ischemia as the main cause of this sign (61%) usually manifests radiologically as pneumatosis intestinalis. Iatrogenic HPVG accounts for 3% and idiopathic origin constitutes less than 2%.2

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