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Portal pyelophlebitis identified by CT scan in a patient with ischemic bowel

A Ghani1, K Kasirajan, J Smith

  • 1Northeastern Ohio Universities College of Medicine, Rootstown, USA.

The American Surgeon
|December 1, 1995
PubMed

Insights

Hepatic portal venous gas (HPVG) indicates ischemic bowel and carries a high mortality rate. Early detection and treatment are crucial for survival, though outcomes remain poor in most cases.

Area of Science:

  • Radiology
  • Gastroenterology
  • Vascular Surgery

Background:

  • Hepatic portal venous gas (HPVG) is a rare radiological finding.
  • It is often associated with bowel ischemia and sepsis.
  • Prompt diagnosis is critical due to the high mortality rate.

Observation:

  • A computed tomogram revealed HPVG in a 65-year-old male.
  • The HPVG was secondary to ischemic bowel.
  • The patient received aggressive surgical and antibiotic treatment.

Findings:

  • Despite intensive treatment, the patient died within 12 hours.
  • Portal pyelophlebitis, indicated by air in the portal venous system, is a grave sign.
  • The mortality rate associated with this condition is very high.

Implications:

  • HPVG is a critical indicator of bowel ischemia.
  • Early recognition and intervention are vital for patient outcomes.
  • Exceptional cases in inflammatory bowel disease patients may have better prognoses.

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