Portal Venous Gas in a Patient with End-Stage Renal Disease-Advanced Research in Gastroenterology & Hepatology-Juniper Publishers

JUNIPER PUBLISHERS-Advanced Research in Gastroenterology & Hepatology




PORTAL VENOUS GAS IN A PATIENT WITH END-STAGE RENAL DISEASE



Authored by Shane P Smith

An 86-year-old man with end-stage renal disease presented with acute epigastric pain during a hemodialysis session. Computed tomography on admission demonstrated extensive gaseous distension of the portal venous system and signs of ileus without bowel necrosis. His constipation and portal venous gas (PVG) completely resolved with conservative management. While PVG can often signal impending decompensation in critically ill patients, it can also be observed in relatively benign processes and does not necessarily correlate with the acuity of illness. Its occurrence in patients undergoing hemodialysis may begin with a low-flow state, which can lead to ischemic injury.


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