Pediatric milk protein allergy causing hepatic portal venous gas: Case report

Area of Science:

• Pediatric Imaging
• Gastroenterology
• Neonatology

Background:

• Hepatic portal venous gas (HPVG) is an uncommon radiographic finding in infants.
• HPVG typically indicates severe gastrointestinal pathology like necrotizing enterocolitis or bowel ischemia.
• Such diagnoses carry significant clinical implications, often necessitating aggressive management.

Observation:

• An 8-week-old male infant with a history of prematurity presented with clinical signs.
• Imaging revealed the presence of hepatic portal venous gas (HPVG).
• The infant's symptoms were ultimately attributed to an underlying milk protein allergy.

Findings:

• Milk protein allergy is identified as a rare etiology for HPVG in infants.
• This diagnosis contrasts with the more common, severe causes of HPVG.
• The infant's condition improved with appropriate dietary modification.

Implications:

• Recognizing milk protein allergy as a cause of HPVG can prevent unnecessary and invasive interventions.
• This finding underscores the importance of considering allergic reactions in the differential diagnosis of HPVG.
• Early identification allows for targeted, conservative management, improving infant outcomes.