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Benign Vomiting-Induced Hepatic Portal Venous Gas: A Case Report.
1Gastroenterology, Queen's Hospital Burton, University Hospital Derby and Burton NHS Foundation Trust, Burton-on-Trent, GBR.
Cureus
|May 19, 2025
Summary
Hepatic portal venous gas (HPVG) can occur in patients with diabetes and kidney disease, even without bowel issues. Conservative treatment, including fluids and insulin, led to rapid recovery and resolution of HPVG.
Area of Science:
- Radiology
- Gastroenterology
- Nephrology
Background:
- Hepatic portal venous gas (HPVG) is a rare radiological finding.
- Traditionally linked to severe bowel pathology like ischemia.
- Recent imaging advances identify benign causes.
Observation:
- A 34-year-old female with type 1 diabetes mellitus, autonomic dysfunction, and stage 4 chronic kidney disease (CKD) presented with severe vomiting, abdominal pain, and malaise.
- CT scan revealed HPVG.
- No evidence of bowel compromise or ischemia was found.
Findings:
- HPVG can be a benign, self-limiting phenomenon.
- Conservative management (IV fluids, antiemetics, insulin) was effective.
- Rapid clinical improvement and HPVG resolution occurred.
Implications:
- Recognizing vomiting-induced HPVG as benign is crucial.
- Careful clinical assessment can prevent unnecessary surgical interventions.
- Highlights the importance of considering non-ischemic causes of HPVG in specific patient populations.
Keywords:
diabetic gastroparesis (dg)hepatic portal vein gasnausea and vomitingradiologicalradiological findingsstarvation ketosisvomittingMore Related Videos
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