+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Severe hyperglycemic shock associated with hepatic portal venous gas

Severe hyperglycemic shock associated with hepatic portal venous gas

Journal of Anesthesia 22(1): 74-76

We report a case of hyperglycemic shock associated with hepatic portal venous gas. A 79-year-old woman with post-stroke depression developed severe tachycardiac atrial fibrillation and hypotension due to hypovolemia caused by severe hyperglycemia, as well as showing disseminated intravascular coagulation (DIC). Continuous intravenous infusion of insulin and volume loading with normal saline gradually achieved normalization of the serum glucose level and hemodynamic stability. However, the DIC did not resolve, and abdominal computed tomography (CT) revealed hepatic portal venous gas (HPVG) in the left lobe of the liver. Surgery was thus considered mandatory. However, because severe hemodynamic lability occurred again immediately after the CT examination, and persisted, surgery could not be performed, and the patient died of septic shock due to bowel perforation. It was concluded that the underlying causes of DIC should be sought promptly, without delay.

(PDF emailed within 0-6 h: $19.90)

Accession: 055739410

Download citation: RISBibTeXText

PMID: 18306020

DOI: 10.1007/s00540-007-0586-y

Related references

Hepatic portal venous gas after shock episode. Journal of Emergency Medicine 40(4): 439-440, 2011

Hepatic transplantation in spite of low portal blood flow division of the portal system with separate portal venous and arterialized caval venous perfusion of the liver. Langenbecks Archiv fuer Chirurgie 374(4): 232-239, 1989

Severe hepatic portal venous gas that spontaneously resolved within a day. Intensive Care Medicine 40(9): 1369-1369, 2015

The Portal And Hepatic Venous System In Shock: An Angiographic And Manometric Study In The Dog. Annals of Surgery 158: 672-684, 1963

Meso-portal bypass in children with portal vein thrombosis: rapid increase of the intrahepatic portal venous flow after direct portal hepatic reperfusion. Journal of Pediatric Surgery 38(8): 1137-1140, 2003

Computed Tomography Identifies Hepatic Portal Venous Gas Caused by Severe Diarrhoea. West Indian Medical Journal (): -, 2015

Portal venous reconstruction in a living liver donor with an anomalous hepatic arterial and portal venous anatomy. Journal of Gastrointestinal Surgery 9(3): 365-368, 2005

Hepatic portal venous gas and portal venous thrombosis following colonoscopy in a patient with terminal ileal Crohn's disease. Bmj Case Reports 2015: -, 2016

Hepatic portal venous gas associated with severe graft-versus-host disease of the gastrointestinal tract. Internal Medicine 51(17): 2417-2421, 2013

Combined hepatic arterial-portal venous and hepatic arterial-hepatic venous perfusions to probe the abundance of drug metabolizing activities: perihepatic venous O-deethylation activity for phenacetin and periportal sulfation activity for acetaminophen in the once-through rat liver preparation. Journal of Pharmacology and Experimental Therapeutics 247(2): 690-700, 1988

Education and Imaging. Gastrointestinal: Hepatic portal venous gas after cardiogenic shock and intraaortic ballon pulsation therapy. Journal of Gastroenterology and Hepatology 25(3): 644-644, 2010

Portal-hepatic venous shunt through a portal aneurysm complicated by hepatic encephalopathy and pulmonary hypertension. Internal Medicine 36(11): 790-793, 1997

Classic pneumatosis intestinalis and hepatic portal venous gas in setting of severe abdominal aorta atherosclerosis. Quantitative Imaging in Medicine and Surgery 3(6): 339-340, 2014

Effect of somatostatin on portal and hepatic hemodynamics and portal venous pressure in cirrhotic patients with portal hypertension. Zhonghua Wai Ke Za Zhi 36(7): 433-435, 2002