{Reference Type}: Journal Article
{Title}: Conservative treatment of hepatic portal venous gas consecutive to a complicated diverticulitis: A case report and literature review.
{Author}: Moser A;Stauffer A;Wyss A;Schneider C;Essig M;Radke A;
{Journal}: Int J Surg Case Rep
{Volume}: 23
{Issue}: 0
{Year}: 2016
暂无{DOI}: 10.1016/j.ijscr.2016.04.042
{Abstract}: <B>UNASSIGNED: </B>Eight days after being diagnosed with multiple small strokes a 71year old male patient is readmitted with suspicion of a petit mal seizure also complained of diarrhoea and abdominal pain. The patient was stable, not febrile and neurologically intact with a slight tenderness in the left lower quadrant. An ultrasound revealed presence of air in the hepatic portal venous system and a suspicion for sigmoid diverticulitis. A CT-scan confirmed both diagnoses. We proceeded with a conservative regimen under close observation. The clinical course and laboratory results were unremarkable.<BR><B>CONCLUSIONS: </B>The review of the literature (PubMed database) triggered 685 items with only one clinical trial establishing a scoring system to detect adult individuals, which need operation.<BR><B>CONCLUSIONS: </B>A pneumoportogram (hepatic portal venous gas, HPVG) is a very rare and usually associated with bowel ischemia and from poor prognosis. The last decades saw the emergence of numerous other aetiologies (also benign) with a shift of paradigm from systematic emergency laparotomies to individual patient selection.