Portal venous gas

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Portal venous gas is the accumulation of gas in the portal vein and its branches. It needs to be distinguished from pneumobilia, although this is usually not too problematic, when associated findings are taken into account along with the pattern of gas (i.e. peripheral in portal venous gas, central in pneumobilia).

Ultrasound and Doppler

Gas in the portal veins usually manifests as an echogenic moving foci in the lumen of the portal vein~~, associated~~

Doppler

Associated with sharp spikes on both sides of the basal line on the Doppler spectral display ⁷.

Pathology

Aetiology

Although traditionally considered a harbinger of death, portal venous gas is increasingly recognised in a variety of conditions, many of which do not carry as high mortality or morbidity risks.

Causes of portal venous gas are best divided according to the age of the patient:

child
- umbilical vein catheterisation
- necrotising enterocolitis (NEC)
- neonatal gastroenteritis
- erythroblastosis fetalis
- postoperative finding in corrective bowel surgery
adult
- alterations of bowel wall
  - ischaemic bowel (usually mural gas as well as mesenteric gas: mortality of 75-90%, but gas is not an independent predictor)
  - necrotic/ulcerated colorectal carcinoma (CRC)
  - inflammatory bowel disease (IBD)
  - perforated peptic ulcer
- bowel luminal distention
  - iatrogenic gastric and bowel dilatation (e.g. upper and lower endoscopic procedures, enemas)
  - paralytic ileus / mechanical bowel obstruction
  - acute gastric dilatation⁴
  - barotrauma
- intra-abdominal sepsis
- unknown mechanism
  - pneumatosis intestinalis
  - chronic obstructive pulmonary disease (COPD)
  - corticosteroid usage

-<p><strong>Portal venous gas</strong> is the accumulation of gas in the <a href="/articles/portal-vein">portal vein</a> and its branches. It needs to be distinguished from <a href="/articles/pneumobilia">pneumobilia</a>, although this is usually not too problematic, when associated findings are taken into account along with the pattern of gas (i.e. peripheral in portal venous gas, central in pneumobilia).</p><h6>Ultrasound and Doppler</h6><p>Gas in the portal veins usually manifests as an echogenic moving foci in the lumen of the portal vein, associated with sharp spikes on both sides of the basal line on the Doppler spectral display <sup>7</sup>.</p><h4>Pathology</h4><h5>Aetiology</h5><p>Although traditionally considered a harbinger of death, portal venous gas is increasingly recognised in a variety of conditions, many of which do not carry as high mortality or morbidity risks.</p><p>Causes of portal venous gas are best divided according to the age of the patient:</p><ul>
+<p><strong>Portal venous gas</strong> is the accumulation of gas in the <a href="/articles/portal-vein">portal vein</a> and its branches. It needs to be distinguished from <a href="/articles/pneumobilia">pneumobilia</a>, although this is usually not too problematic, when associated findings are taken into account along with the pattern of gas (i.e. peripheral in portal venous gas, central in pneumobilia).</p><h4>Ultrasound</h4><p>Gas in the portal veins usually manifests as an echogenic moving foci in the lumen of the portal vein</p><h5>Doppler</h5><p>Associated with sharp spikes on both sides of the basal line on the Doppler spectral display <sup>7</sup>.</p><h4>Pathology</h4><h5>Aetiology</h5><p>Although traditionally considered a harbinger of death, portal venous gas is increasingly recognised in a variety of conditions, many of which do not carry as high mortality or morbidity risks.</p><p>Causes of portal venous gas are best divided according to the age of the patient:</p><ul>

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