A case of hepatic portal venous gas due to viral gastroenteritis
A 71-year-old man with a medical history of diabetes mellitus type II, hypertension, dyslipidemia, and hypothyroidism presented with complaints of acute-onset nausea, vomiting, and abdominal pain. The patient also reported diarrhea, but denied any fevers or chills. The patient had no history of any manipulation of the gastrointestinal system. A physical examination revealed mild abdominal tenderness, pronounced in the upper-and lower-right quadrants, with no peritoneal signs. A computed tomography (CT) scan demonstrated no evidence of an acute intra-abdominal disturbance (). An extensive amount of gas, however, was found in the portal venous system (). Due to the patient’s clinical presentation and stable condition, a conservative management plan, including intravenous fluids and taking nothing by mouth, was implemented.\nCT scanning was repeated 3 hours later. Although the results reflected a diminished amount of portal venous gas, there was no evidence of any acute abdominal pathology that may have caused the hepatic portal venous gas (). After the patient’s nausea, vomiting, and abdominal pain resolved, no further medical interventions were ordered. On day 2 of hospitalization, the patient’s dietary restrictions were lifted and he was discharged. At the 1-month follow-up examination, the patient reported no health problems; a colonoscopy was performed, and results were within normal limits.