{"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":1792425616949,"version":"4.5.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hepatic portal venous gas (HPVG) is a rare but clinically significant radiologic finding associated with diverse intra-abdominal and systemic diseases. Once considered a fatal sign, its prognosis now varies widely due to advances in imaging and supportive care. This study aimed to characterize the clinical features, etiologies, imaging patterns, and prognostic factors of HPVG managed conservatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on 16 patients diagnosed with HPVG by CT between January 2017 and June 2025 at Shiyan People\u2019s Hospital, Hubei University of Medicine. Demographics, comorbidities, laboratory data, imaging findings, and outcomes were reviewed. Group comparisons employed the\n                      <jats:italic>t<\/jats:italic>\n                      -test, Mann\u2013Whitney U, or chi-square test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 16 patients, 11 were male (68.8%), with a mean age of 61.1 \u00b1 15.8 years. The major etiologies were intra-abdominal infection (31.3%), gastrointestinal bleeding (25%), intestinal obstruction (18.8%), and perforation (12.5%). All received conservative management, with an in-hospital mortality rate of 62.5%. Non-survivors had significantly lower serum albumin and higher procalcitonin (PCT) levels, while brain natriuretic peptide (BNP) showed weak association with mortality. Other demographic and biochemical variables showed no significant differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conservatively treated HPVG, hypoalbuminemia and elevated PCT were strongly associated with mortality. Imaging follow-up demonstrated complete gas resolution in several patients after control of the underlying disease, indicating HPVG represents a radiologic manifestation rather than a disease entity. Combined evaluation of imaging dynamics and biomarkers may aid early risk stratification and guide individualized management. Further multicenter prospective studies are warranted to validate these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1745715","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:55:25Z","timestamp":1779962125000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical phenotypes and imaging evolution of hepatic portal venous gas under conservative management: a single-center case series using albumin and procalcitonin as prognostic stratification anchors"],"prefix":"10.3389","volume":"13","author":[{"given":"Biao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of General Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengwei","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan","place":["Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihua","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1080\/15563650.2025.2605133","article-title":"Transient hepatic portal venous gas following resuscitated cardiac arrest in a patient with aconitine poisoning.","volume":"64","author":"Wang","year":"2026","journal-title":"Clin Toxicol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1016\/j.mayocp.2025.03.012","article-title":"Hepatic portal venous gas.","volume":"100","author":"He","year":"2025","journal-title":"Mayo Clin Proc."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1540418","DOI":"10.3389\/fmed.2025.1540418","article-title":"Clinical characteristics and treatment of hepatic portal venous gas: case series and literature review.","volume":"12","author":"Wei","year":"2025","journal-title":"Front Med."},{"key":"B4","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":"B5","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12245-025-00837-z","article-title":"Hepatic portal venous gas associated with ischemic colitis: a case report.","volume":"18","author":"Lin","year":"2025","journal-title":"Int J Emerg Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1055\/a-1797-9986","article-title":"Sonographically detected hepatic portal venous gas - prevalence, causes, and clinical implications.","volume":"44","author":"Mehl","year":"2023","journal-title":"Ultraschall Med."},{"key":"B7","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":"B8","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.gastrohep.2019.08.004","article-title":"Spontaneous hepatic portal venous gas in a patient with ulcerative colitis. 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