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Case Report

EJMCR. 2023; 7(3): 60-64


Hepatic portal venous gas in the setting of closed loop small bowel obstruction in a patient with adjustable gastric band: a case report

Mandy Nakhle, Samer Diab, Nadim Mahmoud El Kassir, Pamela Semaan, Rajaa Chatila, Daniel Mahfoud, Georges Al-Hajj, Rodrigue Chemaly.




Abstract

Background: Hepatic portal venous gas (HPVG) has rarely been described in the presence of benign, non-life-threatening conditions such as gastric emphysema and gastric dilatation. In such cases, management and patient prognosis have evolved to become highly dependent on the etiology. Nevertheless, although such conditions can be benign and conservative management can be applied, close monitoring of the patient’s status is necessary to avoid any complication like gastric necrosis.
Case Presentation: We report a case of acute gastric dilatation with HPVG in the presence of gastric emphysema and closed loop small bowel obstruction, complicated by gastric necrosis, in a patient with adjustable gastric band.
Conclusion: HPVG can have benign etiologies which influence its mortality rate, management, and prognosis. These should be detected, and patients should be monitored closely, especially if managed conservatively, to avoid complications.

Key words: Hepatic portal venous gas, adjustable gastric band, gastric dilatation, gastric emphysema, small bowel obstruction, case report.






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