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Dong, Cho, Baek, Kang, Kim, Cho, Lee, and Chun: A Case of Successful Treatment of Portal Venous Gas Caused by Acute Pancreatitis
Case Report

Korean J Gastroenterol 2013;61(3):170-173.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.61.3.170

A Case of Successful Treatment of Portal Venous Gas Caused by Acute Pancreatitis

Shi Heon Dong, Hyeon Geun Cho, Jeong Hoon Baek, Beo Deul Kang, Mi Sung Kim1, Jae Hee Cho, Jeong Hoon Lee2, Song Wook Chun

Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea

1Department of Radiology, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea

2Department of Surgery, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea

Correspondence to: Hyeon Geun Cho, Department of Internal Medicine, Myongji Hospital, Kwandong University College of Medicine, 697-24 Hwajeong-dong, Deogyang- gu, Goyang 412-270, Korea. Tel: +82-31-810-5412, Fax: +82-31-810-5109, E-mail: Chg21@kwandong.ac.kr

Received 13 April 201216 July 2012       Accepted 20 July 2012

Copyright © 2013 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hepatic portal venous gas (HPVG) has been considered a rare entity associated with a poor prognosis. Portal vein gas is most commonly caused by mesenteric ischemia but may have a variety other causes. HPVG can be associated with ischemic bowel disease, inflammatory bowel disease, intraabdominal abscess, small bowel obstruction, acute pancreatitis, and gastric ulcer. Because of high mortality rate, most HPVG requires emergent surgical interventions and intensive medical management. We experienced a case of hepatic portal venous gas caused by acute pancreatitis and successfully treated with medical management.

Keywords: Hepatic portal vein, Superior mesenteric vein, Gas, Acute pancreatitis

References

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Fig. 1.
Acute pancreatitis with portal and superior mesenteric venous gas. (A) CT showed portal vein air (arrows) in the peripheral portion of left hepatic lobe. Loculated fluid collection (F) in the lesser sac and retroperitoneal space. Note hepatomegaly with severe fatty liver indicating alcoholic liver disease. (B) CT revealed air in the superior mesenteric vein (arrow) and swelling of the pancreas (arrowheads) with peripancreatic fluid (F).
kjg-61-170f1.tif
Fig. 2.
Follow-up CT after 2 days. CT scans showed absence of air in the portal vein (A) and superior mesenteric vein (B). Diffuse pancreatic swelling with fluid collection in the perihepatic and retroperitoneal space suggested acute pancreatitis.
kjg-61-170f2.tif
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