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Updated: Jan 3, 2026
Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
Published on: June 18, 2020
Hepatic portal venous gas. Should it be considered as an ominous radiologic sign?
Ana Hernando Sanz1, María Díaz-Tobarra1, Gregorio González Álvarez1
1Cirugía General y del Aparato Digestivo, Complejo Hospitalario de Navarra, España.
Abstract:
Portal pneumatosis is considered as an ominous radiologic sign if it is associated to intestinal ischemia. If sepsis is present, mortality reaches 80-90%. However, in inflammatory disease or infections survival rates are close to 70%. With the aim to reconsider the poor prognosis associated with portal pneumatosis, we would like to present the case of a 63-years-old male who went to the emergency room with abdominal pain and peritoneal irritation. Urgent surgery was indicated, findings were: an area of transmural necrosis located in the antimesenteric sigma's face, and patchy necrosis of the colonic mucose. A Hartmann`s procedure was performed. Nowadays, the pacient underwent surgery for restoration of the continuity of the GI.
Insights
Portal pneumatosis, a concerning sign of intestinal ischemia, can have high mortality if sepsis is present. This case highlights a patient with portal pneumatosis who survived a serious condition, challenging its poor prognosis.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Oncology
Background:
- Portal pneumatosis is a concerning radiological finding often linked to intestinal ischemia and high mortality rates, especially when sepsis is present.
- While typically associated with poor outcomes, this case aims to re-evaluate the prognosis of portal pneumatosis.
Observation:
- A 63-year-old male presented with abdominal pain and peritoneal irritation, indicative of an acute abdominal condition.
- Urgent surgical exploration revealed transmural necrosis of the colon and patchy mucosal necrosis.
Findings:
- The patient underwent a Hartmann's procedure due to the severity of the colonic necrosis.
- Successful surgical intervention and subsequent restoration of gastrointestinal continuity were achieved.
Implications:
- This case suggests that portal pneumatosis, even with severe findings, may not always portend a fatal outcome.
- Reconsidering the prognosis of portal pneumatosis in the absence of sepsis is warranted, emphasizing the importance of timely surgical intervention.
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