Ultrasound evaluation of portal venous gas and its mimics.

Abdom Radiol (NY)

Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.

Published: August 2024


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Portal venous gas on abdominal ultrasound classically represents an indirect indicator of bowel ischemia, a critical condition which poses a high patient mortality and therefore warrants emergent corrective action. While the classic appearance of portal venous gas on ultrasound is well-described in the literature, the characteristic descriptors are nonspecific and may actually represent other less emergent mimics. Therefore, while radiologists should remain vigilant for the detection of findings corresponding to portal venous gas, they should also be aware of similar-appearing entities in order to provide the most accurate diagnosis. This pictorial essay will open with imaging examples of true portal venous gas attributable to bowel ischemia and describe the classic features which should alert radiologists to this specific diagnosis. Subsequently, this pictorial essay will provide imaging examples of other various other clinical entities which on ultrasound may share similar imaging characteristics. An important objective of this pictorial essay is to highlight distinguishing imaging features along with specific clinical circumstances for each pathological entity which can direct radiologists into identifying the correct diagnosis.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00261-024-04328-2DOI Listing

Publication Analysis

Top Keywords

portal venous
20
venous gas
20
pictorial essay
12
bowel ischemia
8
essay will
8
imaging examples
8
portal
5
venous
5
gas
5
ultrasound
4

Similar Publications

Transjugular intrahepatic portosystemic shunt (TIPS) placement is a well-established intervention for portal hypertension. However, some patients experience persistent complications such as encephalopathy, ascites, or thrombocytopenia, especially when further TIPS optimization is not technically possible. Partial splenic embolization (PSE), typically performed for hypersplenism or certain hematologic conditions, can reduce portal venous inflow and improve cytopenias; however, its use as an adjunct to TIPS is less well described.

View Article and Find Full Text PDF

Embolization of Complex Intrahepatic Portosystemic Venous Shunt: A Case Report.

Interv Radiol (Higashimatsuyama)

June 2025

Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan.

An 89-year-old woman presented with altered mental status. Computed tomography revealed multiple shunts between the portal (segment 3) and hepatic veins (left and middle hepatic veins); detailed vascular anatomy of the shunts could not be determined owing to its complexity. Blood tests revealed an elevated ammonia level.

View Article and Find Full Text PDF

Background And Purpose: Predicting hepatocellular carcinoma (HCC) response to Stereotactic Body Radiation Therapy (SBRT) can be challenging. Here, we assessed the value of a radiomics-based machine learning (ML) approach for predicting HCC response to SBRT, using pre-treatment and early post-treatment magnetic resonance imaging (MRI).

Materials And Methods: This retrospective single-center study included 87 patients (M 67, mean age 65.

View Article and Find Full Text PDF

Objectives: Contrast extravasation on imaging studies is a clinical surrogate for bleeding severity. However, the prognostic relevance of this imaging sign needs to be evaluated. The aim of this study was to analyze the impact of contrast extravasation defined by computed tomography (CT) and angiography on massive transfusion and 30-day mortality in patients with acute bleeding undergoing transarterial embolization (TAE).

View Article and Find Full Text PDF

Objectives: Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disorder often complicated by vascular events, with or without antiphospholipid antibody syndrome (APS). This study aimed to explore subclinical venous involvement in SLE using biochemical and imaging modalities, focusing on vein wall thickness (VWT) and inflammation-related biomarkers.

Methods: In this cross-sectional study, 68 SLE patients were categorized based on antiphospholipid antibody (APA) status and clinical APS.

View Article and Find Full Text PDF