Hepatic portal venous gas following emergency endoscopic sclerotherapy of gastric varices.

Abstract

Hepatic portal venous gas (HPVG) is a rare condition, usually associated with extended bowel necrosis or intra-abdominal infection. Herein, we report a case of HPVG following endoscopic sclerotherapy for bleeding gastric varices. A 50-year-old female with a history of alcoholic liver disease was referred to our hospital because of hematemesis. Emergency endoscopic sclerotherapy was performed to control bleeding gastric varices. Twelve hours later, HPVG was demonstrated by ultrasound and confirmed by duplex sonography, which spontaneously resolved 2 hours later. The patient remained well throughout this time, and was released with no major sequelae. This case supports the view that HPVG can also present as a benign finding, in particular, following diagnostic and therapeutic procedures of the gut. The underlying cause determines the clinical significance and prognosis of HPVG.