Hepatic Portal Venous Gas: Review of the Literature and Sonographic Implications

To review the clinical data and sonographic implications of hepatic portal venous gas (HPVG), we collected 447 cases of HPVG from the MEDLINE database and the National Taiwan University Hospital, Taipei, Taiwan database and analyzed etiology, radiographic findings, diagnostic tools, and outcome of all the cases. Among them, 61% of cases were nonischemic bowel disease. Mortality rates are significantly influenced by bowel ischemia and pneumatosis intestinalis. Ultrasound-diagnosed HPVG was more frequently reported after 1980 and associated with etiology. In conclusion, the number of cases with ultrasound-diagnosed HPVG is increasing. The etiology of HPVG should be searched and coincident imaging findings, including pneumatosis intestinalis, should be evaluated.