• Yoshitaka Furuya, Hiroshi Yasuhara, Kaori Ariki, Hironobu Yanagie, Shuji Naka, Tohru Nojiri, Hiroki Shinkawa, Hiroki Niwa, and Toshitaka Nagao.
• Department of Surgery, Teikyo University School of Medicine, Ichihara Hospital, 3426-3 Anegasaki, Ichihara, Chiba 299-0111, Japan.
• Surg. Today. 2002 Jan 1;32(7):655-8.

AbstractA case of transient portal venous gas in the liver following blunt abdominal trauma is described. Computed tomography (CT) demonstrated hepatic portal venous gas 4 h after the injury. An exploratory laparotomy revealed segmental necrosis of the small intestine with a rupture of the bladder. Pneumatosis intestinalis was evident on the resected bowel. A histopathologic study revealed congestion and bleeding in the bowel wall and a great deal of the mucosa had been lost because of necrosis. However, neither thrombus nor atherosclerotic changes were observed in the vessels. A bacteriological examination demonstrated anaerobic bacteria from the bowel mucosa, which was most likely to produce portal venous gas. Although the present case was associated with bowel necrosis, a review of literature demonstrated that portal venous gas does not necessarily indicate bowel necrosis in trauma patients. There is another possibility that the portal venous gas was caused by a sudden increase in the intra-abdominal pressure with concomitant mucosal disruption, which thus forced intraluminal gas into the portal circulation in the blunt trauma patients.

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