[Is hepatic portal venous gas the writing on the wall?].

BACKGROUND

Hepatic portal venous gas, which may occur in conjunction with severe intra-abdominal infections, is associated with a high mortality rate and is considered as an alarm signal.

HISTORY: CT diagnostics revealed hepatic portal venous gas in a 65-year-old patient with advanced perforated sigmoid diverticulitis. This phenomenon was also observed in a 75-year-old patient in association with an upside-down stomach incarceration. Both patients underwent emergency surgery and survived this life-threatening disease.

CONCLUSION

Since hepatic portal gas is usually caused by severe intra-abdominal diseases with a high mortality rate, this warning sign should, at the latest, result in urgent laparotomy, if the indication has not already been established for other reasons.