2088: Portal venous gas: Sonographic appearance and clinical significance

Abstract

Objectives: This study was to investigate the data of patients with sonographic finding of portal venous gas(PVG), to explain its sonographic appearance, incidence and clinical significance. Methods: During four years (from January 2001 through December 2004) at our institution, 67,235 abdominal sonograms were obtained. Sonography evaluated five patients with PVG. All of the examinations were retrospectively analyzed. Results: The incidence of PVG was 0.007 = (5/67,235). PVG was easily confirmed by sonography and its sonographic signs included echogenic, moving foci within the lumen of the portal vein and/or poorly defined, echogenic patches within the hepatic parenchyma. From literature, bowel ischemic diseases were most etiologies for PVG. In our group, the underlying diseases included abdominal abscess (n = 1), necrotizing enterocolitis (n = 1), hepatic transplantation (n = 1) and blunt abdominal trauma (n = 2). In three patients, PVG was thought to be a severe sign of disease and the patients underwent surgery. For the others, PVG had no influence on disease and the patients kept conservative treatments. All five patients recovered quickly. Conclusions: PVG is a rare but easily identified sonographic sign, which can be caused by multiple diseases. Sonographic findings of PVG were very helpful to make further diagnosis and proper treatment of those underlying diseases.