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.
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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](/upload/SynapseXML/0028kjg/thumb/kjg-61-170f1.gif)