Six new cases of hepatic portal venous gas (HPVG) and forty-six previously reported cases are reviewed. Roentgenographically, gas in the intrahepatic ramifications of the portal vein characteristically appears as branching, tubular lucencies extending from the porta hepatis to the edge of the liver. Generally, patients with this sign are critically ill and have intestinal distention, often accompanied by abdominal pain, vomiting and diarrhea. In most instances HPVG probably results from gas-forming organisms which gain entry into the portal venous system via a disrupted intestinal mucosa. Over 90 per cent of those affected die. Treatment should be directed toward correcting the underlying disorder which usually is intestinal infarction in adults and enterocolitis in infants.
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