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Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
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Portal venous gas in a girl with chronic intestinal pseudoobstruction

Julia Elrod1, Konrad Reinshagen1, Michael Boettcher1

  • 1Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Germany.

Surgery
|April 27, 2021
PubMed

Insights

Hepatic portal venous gas (HPVG) in chronic intestinal pseudoobstruction (CIPO) can be managed conservatively. This approach avoids high surgical risks in CIPO patients, offering a safer alternative for HPVG management.

Area of Science:

  • Gastroenterology
  • Abdominal Surgery
  • Radiology

Background:

  • Hepatic portal venous gas (HPVG) often indicates critical intra-abdominal conditions necessitating surgery.
  • Chronic intestinal pseudoobstruction (CIPO) is a motility disorder typically managed non-surgically.
  • HPVG in CIPO arises from intestinal dilation, posing a management dilemma.

Observation:

  • A case of HPVG in a CIPO patient is presented.
  • The patient with HPVG and CIPO was treated conservatively.
  • Surgical intervention in CIPO patients carries significant risks.

Findings:

  • Conservative management of HPVG in CIPO is a viable option.
  • Surgery in CIPO patients is linked to high morbidity, mortality, and reoperation rates.
  • Intestinal resection can exacerbate CIPO and lead to refractory ileus.

Implications:

  • Conservative management may be preferred for HPVG in CIPO to avoid surgical complications.
  • This case highlights the importance of considering non-operative strategies for HPVG in specific patient populations.
  • Further research into optimal HPVG management in CIPO is warranted.

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