ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1540418
Clinical characteristics and treatment of hepatic portal venous gas: Case series and literature review
Provisionally accepted
- Hangzhou First People's Hospital, Hangzhou, Zhejiang Province, China
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Background: Hepatic portal venous gas (HPVG) is often regarded as a critical warning sign and has poor patient prognosis if appropriate treatment measures are not promptly administered. There is significant heterogeneity in clinical manifestations, diagnostic approaches, and outcomes among patients with HPVG; hence, this study aimed to analyze the clinical characteristics of patients with HPVG and explore more effective treatment methods to provide valuable references for future clinical treatment strategies.Methods: A total of 21 patients diagnosed with HPVG using computed tomography at the First People's Hospital of Hangzhou between January 2014 and October 2024 were retrospectively analyzed. A comprehensive analyses of the sex, age, laboratory test results, reasons for admission, comorbidities, treatment methods, and outcomes of patients were done. Results: The mean age of the 21 patients (13 men and 8 women) was 61.7 years. Patients presented with decreased red blood cell and hemoglobin counts, and increased white blood cell, neutrophil, C-reactive protein, and D-dimer levels. The main etiologies of HPVG were peritonitis (52.4%), post-abdominal surgery (47.6%), intestinal necrosis (33.3%), and gastrointestinal bleeding (28.6%), while the common comorbidities were peritonitis (52.4%), hypertension (52.4%), and coronary heart disease (23.8%). The overall mortality rate of patients with HPVG was 28.6%, and most of the deceased patients had bowel necrosis. Platelet count (odds ratio [OR]: 0.979; 95% confidence interval [CI]: 0.962–0.997; P=0.024) and neutrophil levels, (OR: 1.161; 95% CI: 1.019–1.323; P=0.025), and the presence of hypertension (OR: 15.750; 95% CI: 1.424–174.246; P=0.025) and peritonitis (OR: 15.750; 95% CI: 1.424–174.246; P=0.025) were significantly associated with the likelihood of requiring surgical intervention. Most patients had a good prognosis after surgical treatment.Conclusion: This study systematically described the clinical characteristics, etiologies, comorbidities, and prognosis of patients with HPVG and identified predictors indicating the need for surgical intervention.
Keywords: Hepatic portal venous gas, Clinical Characteristics, Treatment, prognosis, literature review
Received: 23 Jan 2025; Accepted: 10 Apr 2025.
Copyright: © 2025 Wei, Kong, QIANG, Dong, Zhou, Yang, Shi and Ji. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wen-Cheng Kong, Hangzhou First People's Hospital, Hangzhou, 310006, Zhejiang Province, China
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