Hepatic portal venous gas in the setting of closed loop small bowel obstruction in a patient with adjustable gastric band: a case report
Authors: Mandy Nakhle, Samer Diab, Nadim Mahmoud El Kassir, Pamela Semaan, Rajaa Chatila, Daniel Mahfoud, Georges Al-Hajj, Rodrigue Chemaly
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.
Keywords: Hepatic portal venous gas, adjustable gastric band, gastric dilatation, gastric emphysema, small bowel obstruction, case report.
Authors
Samer Diab
Department of General Surgery, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
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Nadim Mahmoud El Kassir
Department of General Surgery, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
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Pamela Semaan
Department of Radiology, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
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Rajaa Chatila
Department of Internal Medicine, Division of Gastroenterology, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
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Daniel Mahfoud
Department of Radiology, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
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Georges Al-Hajj
Department of General Surgery, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon
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Rodrigue Chemaly
Department of General Surgery, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon.
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Correspondence to:
Nadim Mahmoud El Kassir, Department of General Surgery, Lebanese American University Medical Center - Rizk Hospital, LAU Gilbert and Rose-Marie Chagoury School of Medicine, Beirut, Lebanon nadimmahmoudkassir@gmail.com
Publication history:
Received 15 Sep 2022
Revised 08 Jan 2023
Accepted 02 Feb 2023
Published online 24 Feb 2023
Published in print 07 Mar 2023