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September 1982

Gas in the Hepatic Portal Venous System: A Diagnostic Clue to an Occult Intra-abdominal Abscess

Author Affiliations

From the Divisions of Infectious Diseases (Dr Bach), and the Departments of Medicine (Drs Bach and Anderson) and Surgery (Drs Martin and McAfee), Maine Medical Center, Portland.

Arch Intern Med. 1982;142(9):1725-1726. doi:10.1001/archinte.1982.00340220153025

• Gas within the hepatic venous system on abdominal roentgenogram prompted exploratory laparotomy in a patient with repeated rigors and high fever following total hip replacement. Although the patient had no localizing abdominal symptoms or signs, an intra-abdominal abscess was found and cured by surgical drainage and antibiotics. Occult, life-threatening, but treatable abdominal disease may be detected by the unusual roentgenographic finding of portal venous gas.

(Arch Intern Med 1982;142:1725-1726)