Hepatic Portal Venous Gas in Ultrasonogram—Benign or Noxious

Pan, Huay-Ben; Huang, Jer-Shyung; Yang, Tsung-Lung; Liang, Huei-Lung

doi:10.1016/j.ultrasmedbio.2007.01.014

« Previous Next »Ultrasound in Medicine and Biology
Volume 33, Issue 8 , Pages 1179-1183, August 2007

Hepatic Portal Venous Gas in Ultrasonogram—Benign or Noxious

Huay-Ben Pan
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Radiation Technology, I-Shou University, Kaohsiung, Taiwan
- School of Medical, National Yang-Ming University, Taipei, Taiwan
Jer-Shyung Huang
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medical, National Yang-Ming University, Taipei, Taiwan
Tsung-Lung Yang
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medical, National Yang-Ming University, Taipei, Taiwan
Huei-Lung Liang
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medical, National Yang-Ming University, Taipei, Taiwan
- Address correspondence to: Huei-Lung Liang, MD, Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, Taiwan 813, ROC.

Received 12 July 2006; received in revised form 5 January 2007; accepted 12 January 2007. published online 10 May 2007.

Abstract

The purpose of this study was to investigate and differentiate the characteristics of benign hepatic portal venous gas (HPVG) and noxious HPVG on sonographic images. This study included seven patients (age 65 to 89 y; mean 75 y) with sonograms and computed tomography (CT) images performed within 4-h interval. The sonographic findings of HPVG could be categorized into three patterns: (1) dot-like pattern in two patients; (2) streak-like pattern in three patients; and (3) fruit-pulp-like pattern in two. In the cases of dot-like pattern, it is of a benign transient situation; this phenomenon may be only demonstrated on sonograms but not necessarily on CT. The prognosis is more favorable and any subsequent CT may not be required. In the cases of streak-like or fruit-pulp-like patterns without localized liver lesions (e.g., abscess), it usually indicates a noxious scenario with worse clinical sequelae. We concluded that the identification of sonographic patterns of HPVG might be important to predict patient’s outcome. (E-mail: hlliang@vghks.gov.tw)

Key Words: Portal venous gas, Pattern of gas, Amount of gas, Ultrasonography, Computed tomography