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Case Reports in Surgery
Volume 2013 (2013), Article ID 637951, 5 pages
Case Report

Hepatic Portal Venous Gas: Comparison of Two Cases

Department of Upper GI and Laparoscopic Surgery, Ealing Hospital NHS Trust, London, Uxbridge Road, Southall, UB1 3HW, UK

Received 11 August 2013; Accepted 11 September 2013

Academic Editors: N. A. Chowdri, P. De Nardi, G. Santori, and S. Tatebe

Copyright © 2013 Iain Rankin and Hemant Sheth. 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.


Context. Hepatic portal venous gas (HPVG) is a rare and sinister finding. Its mortality is associated with the underlying causative condition. When secondary to bowel ischaemia, mortality rates exceed 50%. Case Report. Two cases of HPVG are described. One case describes HPVG in association with gastric ischaemia, with complete resolution following conservative management. The second case describes HPVG in association with widespread intra-abdominal ischaemia, with resultant mortality. Conclusion. A “watch and wait” management of HPVG associated with gastric ischaemia is suggested in certain patients, with a low threshold for surgical intervention. HPVG associated with bowel ischaemia is an absolute indication for surgical intervention, where intervention may change the clinical course.