J Surg Surg Educ | Volume 1, Issue 1 | Case Series | Open Access

CT Diagnosis of Air Embolism of Splenic-Mesenteric-Portal System in Two Cases of Bowel Infarction. Basic Elements of Differential Diagnosis with Pneumobilia

Matilde Lico¹, Giancarlo Gismondo Velardi^1*, Angela Teti¹, Rosario Maccarone¹, Saverio Loria², Giuseppe Loria³, Giuseppe Casuscelli Di Tocco¹, Letterio Militano¹, Ilaria Vittoria Trecroci¹, Francesco Loria¹

¹Department of Radiology, "Jazzolino Hospital", ASP Vibo Valentia, Italy
²University School of Medicine “Magna Graecia”, Italy
³Department of Radiology, "Giovanni Paolo II Hospital", ASP Catanzaro, Italy

^*Correspondance to: Giancarlo Gismondo Velardi 

Abstract

The presence of Portal Venous Gas (HPVG) represents a serious and rare occurrence associated with an unfavorable prognostic evolution in patient with acute abdomen. A prompt and correct diagnosis is mandatory for therapeutic planning in these patients [1]. Plain film of the abdomen is the first examination in patients with acute abdomen and displayed portal venous gas as a branched radiolucency extending up to 2 cm below the hepatic capsule. This finding is very difficult to detect and differentiate from pneumobilia based only on gas distribution [1]. Second-line examinations such as ultrasonography and CT have shown greater reliability in both detection and differential diagnosis with pneumobilia. Currently, the increased use of CT and ultrasound allows early and highly sensitive detection of the underlying pathology [2]. We report below two cases of portal gas with involvement of the spleno-porto-mesenteric venous system.

Keywords:

HPVG; Branched radiolucency; Gas embolism; Intramural gas; Splenic-mesenteric venous axis

Citation:

Lico M, Velardi GG, Teti A, Maccarone R, Loria S, Loria G, et al. CT Diagnosis of Air Embolism of Splenic-Mesenteric- Portal System in Two Cases of Bowel Infarction. Basic Elements of Differential Diagnosis with Pneumobilia. J Surg Surg Educ. 2024;1(1):1002..