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2022, Number 1

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Acta Med 2022; 20 (1)

Pneumobilia or portal venous gas? Clinical, diagnostic and therapeutic implications

Garteiz MD, Mora TÓA, Weber SA, Calva AM, Zatarain GA
Full text How to cite this article 10.35366/103561

DOI

DOI: 10.35366/103561
URL: https://dx.doi.org/10.35366/103561

Language: Spanish
References: 15
Page: 74-78
PDF size: 169.35 Kb.


Key words:

Pneumobilia, portal venous gas, radiology, diagnosis.

ABSTRACT

Introduction: The differentiation, in the radiological interpretation, between pneumobilia and portal gas has clinical and therapeutic implications of great importance. The present work is focused on describing the most relevant radiologic and clinical criteria of these two entities, with the objective of reducing confusion among them. Case report: A 40-year-old male patient, with gastrointestinal symptoms, whose simple abdominal X-ray is misinterpreted as having pneumobilia due to the presence of radiolucent areas in the liver parenchyma, leading to further unnecessary studies and increased morbidity. Conclusion: Being able to differentiate pneumobilia from portal gas y a challenge that requires close cooperation between clinicians and radiologists. Both circumstances can be related to pathologies with a wide range of severities and therefore, the integration of a diagnosis must be carefully complemented by the clinical scenario and the radiologic images.


REFERENCES

  1. Sherman SC, Tran H. Pneumobilia: benign or life-threatening. J Emerg Med. 2006; 30 (2): 147-153.

  2. Abboud B, El Hachem J, Yazbeck T, Doumit C. Hepatic portal venous gas: physiopathology, etiology, prognosis and treatment. World J Gastroenterol. 2009; 15 (29): 3585-3590.

  3. Franken JM, Veen EJ. Hepatic portal venous gas. J Gastrointestin Liver Dis. 2010; 19 (4): 360.

  4. Wiesner W, Mortelé KJ, Glickman JN, Ji H, Ros PR. Pneumatosis intestinalis and portomesenteric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. AJR Am J Roentgenol. 2001; 177 (6): 1319-1323.

  5. Peloponissios N, Halkic N, Pugnale M, Jornod P, Nordback P, Meyer A et al. Hepatic portal gas in adults: review of the literature and presentation of a consecutive series of 11 cases. Arch Surg. 2003; 138 (12): 1367-1370.

  6. Kinoshita H, Shinozaki M, Tanimura H, Umemoto Y, Sakaguchi S, Takifuji K et al. Clinical features and management of hepatic portal venous gas: four case reports and cumulative review of the literature. Arch Surg. 2001; 136 (12): 1410-1414.

  7. Liebman PR, Patten MT, Manny J, Benfield JR, Hechtman HB. Hepatic--portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg. 1978; 187 (3): 281-287.

  8. Nelson AL, Millington TM, Sahani D, Chung RT, Bauer C, Hertl M et al. Hepatic portal venous gas: the ABCs of management. Arch Surg. 2009; 144 (6): 575-5781; discussion 581.

  9. Griffiths DM, Gough MH. Gas in the hepatic portal veins. Br J Surg. 1986; 73 (3): 172-176.

  10. Huurman VA, Visser LG, Steens SC, Terpstra OT, Schaapherder AF. Persistent portal venous gas. J Gastrointest Surg. 2006; 10 (5): 783-785.

  11. Rajkovic Z, Papes D, Altarac S, Arslani N. Differential diagnosis and clinical relevance of pneumobilia or portal vein gas on abdominal X-ray. Acta Clin Croat. 2013; 52 (3): 369-373.

  12. Lewandowski BJ, Withers C, Winsberg F. The air-filled left hepatic duct: the saber sign as an aid to the radiographic diagnosis of pneumobilia. Radiology. 1984; 153 (2): 329-332.

  13. Pan HB, Huang JS, Yang TL, Liang HL. Hepatic portal venous gas in ultrasonogram--benign or noxious. Ultrasound Med Biol. 2007; 33 (8): 1179-1183.

  14. Moussa M, Marzouk I, Abdelmoula K, Manamani A, Dali N, Farhat LC et al. Role of computed tomography in predicting prognosis of hepatic portal venous gas. Int J Surg Case Rep. 2017; 30: 177-182.

  15. Ginesu GC, Barmina M, Cossu ML, Feo CF, Fancellu A, Addis F et al. Conservative approach to Hepatic Portal Venous Gas: A case report. Int J Surg Case Rep. 2017; 30: 183-185.




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Acta Med. 2022;20