A healthy young patient with hepatic portal vein gas due to acute gastric dilatation: a case report.

Publisher: Springer Japan Country of Publication: Japan NLM ID: 101477246 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1865-7265 (Electronic) Linking ISSN: 18657265 NLM ISO Abbreviation: Clin J Gastroenterol Subsets: MEDLINE

Original Publication: [Tokyo] : Springer Japan

Portal Vein*/diagnostic imaging ; Gastric Dilatation*/diagnostic imaging ; Gastric Dilatation*/etiology; Humans ; Male ; Adult ; Tomography, X-Ray Computed ; Necrosis

Hepatic portal vein gas (HPVG) is caused by the influx of gastrointestinal gas into the intrahepatic portal vein as a result of gastrointestinal wall fragility due to ischemia or necrosis. Gastrointestinal tract necrosis is fatal in severe cases. We observed a case of food intake-induced acute gastric dilatation (AGD) in a healthy young male who developed HPVG and underwent conservative treatment. A 25-year-old male presented to our hospital with epigastric pain and nausea the day after excessive food intake. Computed tomography (CT) revealed gas along the intrahepatic portal vein and marked gastric dilatation with large food residue. AGD-induced HPVG was considered. Esophagogastroduodenoscopy (EGD) was not performed at this stage because of the risk of HPVG and AGD exacerbation, and the patient was followed up with intragastric decompression via a nasogastric tube. Food residue and approximately 2 L of liquid without blood were vomited 1 h after the nasogastric tube placement. His symptoms improved after the vomiting episode. An EGD was performed 2 days after undergoing CT. Endoscopic findings revealed extensive erosions and the presence of a whitish coat extending from the fornix to the lower body of the stomach, indicating AGD. HPVG disappeared on the CT scan taken during EGD. Thereafter, symptom relapse and HPVG recurrence were not observed.
(© 2023. Japanese Society of Gastroenterology.)

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Keywords: Abdominal distention; Acute gastric dilatation; Gastric ischemia; Gastric mucosal lesion; Hepatic portal vein gas

Date Created: 20230411 Date Completed: 20230721 Latest Revision: 20230721

20250114

10.1007/s12328-023-01797-8

37040045