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October 1997

Portal Vein Gas, a Changing Clinical Entity: Report of 7 Patients and Review of the Literature

Author Affiliations

From the Departments of Surgery, The New York Hospital—Cornell Medical Center, New York, NY (Drs Hong and Davis); the North Shore University Hospital, Manhasset, NY (Drs Gadaleta and Rossi); and The New York Hospital Medical Center of Queens, Queens (Dr Esquivel).

Arch Surg. 1997;132(10):1071-1075. doi:10.1001/archsurg.1997.01430340025003


To assess the clinical significance of portal vein gas (PVG) demonstrated by computed tomography (CT). 

Design:  Review of medical records.

Setting:  Three network-affiliated hospitals providing both primary community-based and tertiary services.

Methods:  Review of diagnosis, clinical circumstances, and significance of PVG in 7 patients detected by CT during a 3-year period in 3 affiliated hospitals.

Results:  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.

Conclusions:  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.Arch Surg. 1997;132:1071-1075