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Case Reports in Gastrointestinal Medicine
Volume 2017, Article ID 8185132, 4 pages
https://doi.org/10.1155/2017/8185132
Case Report

A Case of Hepatic Portal Venous Gas: Hypothesis of a Transient Direct Communication between a Penetrating Antral Gastric Ulcer and Mesenteric Varices

1Division of Internal Medicine, Steward Carney Hospital, Tufts School of Medicine, Dorchester, MA, USA
2Division of Gastroenterology and Hepatology, Steward Carney Hospital, Tufts School of Medicine, Dorchester, MA, USA
3Division of Pulmonology and Critical Care, Steward Carney Hospital, Tufts School of Medicine, Dorchester, MA, USA
4Division of Gastroenterology and Hepatology, Tufts Medical Center, Tufts School of Medicine, Boston, MA, USA

Correspondence should be addressed to Hassan M. Ghoz; moc.liamg@zohgnassah

Received 14 December 2016; Accepted 12 February 2017; Published 26 February 2017

Academic Editor: Yoshihiro Moriwaki

Copyright © 2017 Hassan M. Ghoz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hepatic portal venous gas (HPVG) is a rare radiological sign that usually signifies an acute intra-abdominal process, most commonly bowel ischemia and sepsis. Few reports described an association with underlying gastric pathologies. We report a 60-year-old patient who presented with melena and chills and was discovered to have a gastric ulcer that appeared to have penetrated into a mesenteric varix. This, in turn, likely caused development of HPVG associated with fungemia. Treatment with a proton pump inhibitor and bowel rest was sufficient to resolve symptoms and the HPVG.