J Korean Med Sci.  2011 Aug;26(8):1108-1110. 10.3346/jkms.2011.26.8.1108.

A Case of Hepatic Portal Venous Gas as a Complication of Endoscopic Balloon Dilatation

• Lee CG
• Kang HW
• Song MK
• Kim JH
• Lee JK
• Lim YJ
• Koh MS
• Lee JH

• KMID: 1777853
• DOI: http://doi.org/10.3346/jkms.2011.26.8.1108

Abstract

The development of hepatic portal venous gas (HPVG) is rare but it might be associated with serious disease and poor clinical outcome. Recently, several iatrogenic causes of HPVG have been reported. HPVG as a complication of endoscopic balloon dilatation is a previously unreported event. We experienced a case of HPVG after endoscopic balloon dilatation in a 31 yr-old man with pyloric stricture due to corrosive acids ingestion. The patient was treated conservatively with fluid resuscitation, antibiotics and Levin tube with natural drainage. Five days later, the follow-up CT scan showed spontaneous resolution of HPVG. This case reminded us the clinical importance and management strategy of HPVG. We report here a case of iatrogenic HPVG with a review of relevant literature.

Keyword

Hepatic Portal Venous Gas; Endoscopic Balloon Dilatation; Pyloric Stricture

MeSH Terms

Adult
Balloon Dilation/*adverse effects
Embolism, Air/etiology/*radiography/therapy
Endoscopy, Gastrointestinal
Hepatic Veins/*radiography
Humans
Male
Portal Vein/*radiography
Pyloric Stenosis/therapy
Tomography, X-Ray Computed

Figure

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  Fig. 1 Endoscopic findings. (A) Severe pyloric stricture was observed, followed by a caustic lye injury 4 weeks later. (B) After endoscopic balloon dilatation, pyloric stricture was improved and endoscopy passage was possible. Only mild mucosal injury was found.

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  Fig. 2 Enhanced abdomen CT findings. (A) Enhanced abdominal CT finding after balloon dilatation. Massive hepatic portal venous gas is observed. (B) Enhanced abdominal CT five days later is shown. Spontaneous resolution of amounts of hepatic portal venous gas is observed.

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