{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:00:16Z","timestamp":1792425616980,"version":"4.5.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 21 patients diagnosed with HPVG using computed tomography at the First People\u2019s 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age of the 21 patients (13 men and 8 women) was 61.7\u202fyears. 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\u20130.997; <jats:italic>p<\/jats:italic>\u202f=\u202f0.024] and neutrophil levels, (OR: 1.161; 95% CI: 1.019\u20131.323; <jats:italic>p<\/jats:italic>\u202f=\u202f0.025), and the presence of hypertension (OR: 15.750; 95% CI: 1.424\u2013174.246; <jats:italic>p<\/jats:italic>\u202f=\u202f0.025) and peritonitis (OR: 15.750; 95% CI: 1.424\u2013174.246; <jats:italic>p<\/jats:italic>\u202f=\u202f0.025) were significantly associated with the likelihood of requiring surgical intervention. Most patients had a good prognosis after surgical treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study systematically described the clinical characteristics, etiologies, comorbidities, and prognosis of patients with HPVG and identified predictors indicating the need for surgical intervention.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1540418","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T05:34:51Z","timestamp":1746768891000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical characteristics and treatment of hepatic portal venous gas: case series and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Hao-Ran","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Qiang","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan-He","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin-Po","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye-Bin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Hao","family":"Ji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Cheng","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.ajem.2020.06.085","article-title":"Hepatic portal venous gas: a case report and analysis of 131 patients using PUBMED and MEDLINE database","volume":"45","author":"Liu","year":"2021","journal-title":"Am J Emerg Med"},{"key":"ref2","first-page":"486","article-title":"Gas in the portal veins of the liver in infants; a roentgenographic demonstration with postmortem anatomical correlation","volume":"74","author":"Wolfe","year":"1955","journal-title":"Am J Roentgenol Radium Therapy, Nucl Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1097\/00000658-197803000-00012","article-title":"Hepatic--portal venous gas in adults: etiology, pathophysiology and clinical significance","volume":"187","author":"Liebman","year":"1978","journal-title":"Ann Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/1749-7922-3-21","article-title":"Portal vein gas in emergency surgery","volume":"3","author":"Hussain","year":"2008","journal-title":"World J Emerg Surg"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.1007\/s00384-007-0346-3","article-title":"Intermittent hepatic portal vein gas complicating diverticulitis--a case report and literature review","volume":"22","author":"Sellner","year":"2007","journal-title":"Int J Color Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1148\/radiographics.20.5.g00se011213","article-title":"Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis","volume":"20","author":"Sebasti\u00e0","year":"2000","journal-title":"Radiographics"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2953","DOI":"10.3748\/wjg.v11.i19.2953","article-title":"Computed tomography findings in fatal cases of enormous hepatic portal venous gas","volume":"11","author":"Chan","year":"2005","journal-title":"World J Gastroenterol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.2214\/ajr.169.6.9393159","article-title":"Outcome of 17 patients with portal venous gas detected by CT","volume":"169","author":"Faberman","year":"1997","journal-title":"AJR Am J Roentgenol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1001\/archsurg.2009.88","article-title":"Hepatic portal venous gas: the ABCs of management","volume":"144","author":"Nelson","year":"2009","journal-title":"Arch Surg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1100\/tsw.2008.133","article-title":"Benign hepatic portal venous gas in a critically ill patient","volume":"8","author":"Gorospe","year":"2008","journal-title":"Sci World J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"3585","DOI":"10.3748\/wjg.15.3585","article-title":"Hepatic portal venous gas: physiopathology, etiology, prognosis and treatment","volume":"15","author":"Abboud","year":"2009","journal-title":"World J Gastroenterol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1410","DOI":"10.1001\/archsurg.136.12.1410","article-title":"Clinical features and management of hepatic portal venous gas: four case reports and cumulative review of the literature","volume":"136","author":"Kinoshita","year":"2001","journal-title":"Arch Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.3748\/wjg.v26.i14.1628","article-title":"Optimal treatment strategies for hepatic portal venous gas: a retrospective assessment","volume":"26","author":"Gonda","year":"2020","journal-title":"World J Gastroenterol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/j.gastrohep.2020.02.018","article-title":"Hepatic portal venous gas, a potentially serious radiological finding","volume":"43","author":"Abad","year":"2020","journal-title":"Gastroenterol Hepatol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1007\/s12328-021-01468-6","article-title":"Conservative treatment of hepatic portal venous gas resulting from non-occlusive mesenteric ischemia: a case report","volume":"14","author":"Seike","year":"2021","journal-title":"Clin J Gastroenterol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e937197","DOI":"10.12659\/AJCR.937197","article-title":"Hepatic portal venous gas: a potentially lethal sign demanding urgent management","volume":"23","author":"Zhou","year":"2022","journal-title":"Am J Case Rep"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1007\/s00268-017-4189-y","article-title":"In-hospital mortality for hepatic portal venous gas: analysis of 1590 patients using a Japanese National Inpatient Database","volume":"42","author":"Koizumi","year":"2018","journal-title":"World J Surg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1007\/s11605-011-1661-0","article-title":"Hepatic portal venous gas: a warning sign!?","volume":"16","author":"D'Haeninck","year":"2012","journal-title":"J Gastrointest Surg"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1007\/s12328-019-01020-7","article-title":"A case of phlegmonous gastritis with hepatic portal venous gas caused by Aeromonas hydrophila successfully treated with medication","volume":"13","author":"Yasuda","year":"2020","journal-title":"Clin J Gastroenterol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1177\/000313480807400412","article-title":"Computed tomographic evidence of hepatic portal venous gas after blunt abdominal trauma does not necessitate surgery","volume":"74","author":"Vercruysse","year":"2008","journal-title":"Am Surg"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"879","DOI":"10.3748\/wjg.15.879","article-title":"Extensive hepatic-portal and mesenteric venous gas due to sigmoid diverticulitis","volume":"15","author":"Sen","year":"2009","journal-title":"World J Gastroenterol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1097\/MCG.0b013e318030ffc3","article-title":"Pneumatosis intestinalis and hepatic portal venous gas caused by gastrointestinal perforation with amyloidosis","volume":"42","author":"Yamamoto","year":"2008","journal-title":"J Clin Gastroenterol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1007\/s13730-020-00522-5","article-title":"Peritoneal dialysis-related peritonitis complicated with nonocclusive mesenteric ischemia","volume":"10","author":"Oda","year":"2021","journal-title":"CEN Case Rep"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1159\/000444444","article-title":"Clinical evaluation of hepatic portal venous gas after abdominal surgery","volume":"10","author":"Okada","year":"2016","journal-title":"Case Rep Gastroenterol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1111\/j.1742-6723.2010.01274.x","article-title":"Hepatic portal venous gas in a patient with intestinal necrosis","volume":"22","author":"Siswojo","year":"2010","journal-title":"Emerg Med Australas"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"4260","DOI":"10.1016\/j.radcr.2022.08.048","article-title":"Transient portal venous gas in upper gastrointestinal bleeding: a case report","volume":"17","author":"Pourhajihosseini","year":"2022","journal-title":"Radiol Case Rep"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1136\/emj.2010.104117","article-title":"Characteristics of high-echoic objects in the hepatic vessels of patients with cardiopulmonary arrest: a prospective cohort study","volume":"29","author":"Arata","year":"2012","journal-title":"Emerg Med J"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s40477-024-00920-w","article-title":"A rare case of hepatic portal venous gas (HPVG) diagnosed as emphysematous cystitis in an elderly diabetic dialysis patient","volume":"28","author":"Rahmani","year":"2024","journal-title":"J Ultrasound"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1007\/s00540-007-0586-y","article-title":"Severe hyperglycemic shock associated with hepatic portal venous gas","volume":"22","author":"Nishikawa","year":"2008","journal-title":"J Anesth"},{"key":"ref30","first-page":"74","article-title":"Hepatic portal venous gas--three non-fatal cases and review of the literature","volume":"81","author":"McElvanna","year":"2012","journal-title":"Ulster Med J"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.ajg.2016.08.004","article-title":"A case of hepatic portal venous gas after colonoscopy","volume":"17","author":"Solakoglu","year":"2016","journal-title":"Arab J Gastroenterol"},{"key":"ref32","first-page":"71","article-title":"Bilateral emphysematous pyelonephritis with hepatic portal venous gas: case report","volume":"22","author":"Cheng","year":"2015","journal-title":"Malays J Med Sci"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1540418\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T05:34:52Z","timestamp":1746768892000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1540418\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,9]]},"references-count":32,"alternative-id":["10.3389\/fmed.2025.1540418"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1540418","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,9]]},"article-number":"1540418"}}