Why is there portal venous gas in NEC?
Portal gas is much more dramatically observed on ultrasonography. Although once heralded as an ominous sign in NEC, portal gas is now believed to be less so. It is caused by gas produced by bacteria in the portal veins or by the transmigration of gas from the bowel wall to mesenteric veins and into the portal vein.
What causes portal vein gas?
The commonest cause for portal vein gas was bowel ischemia and mesenteric vascular pathology (61.44%). This was followed by inflammation of the gastrointestinal tract (16.26%), obstruction and dilatation (9.03%), sepsis (6.6%), iatrogenic injury and trauma (3.01%) and cancer (1.8%).
What is portal gas?
Portal venous gas is the accumulation of gas in the portal vein and its branches. It needs to be distinguished from pneumobilia, although this is usually not too problematic when associated findings are taken into account along with the pattern of gas (i.e. peripheral in portal venous gas, central in pneumobilia).
What is hepatic portal venous gas?
Hepatic portal venous gas (HPVG), an ominous radiologic sign, is associated in some cases with a severe underlying abdominal disease requiring urgent operative intervention. HPVG has been reported with increasing frequency in medical literature and usually accompanies severe or lethal conditions.
What is the role of portal vein?
The portal vein is a blood vessel that delivers blood to the liver from the stomach, intestines, spleen, and pancreas. Most of the liver’s blood supply is delivered by the portal vein.
Is NEC curable?
NEC can be cured and have little or no lasting effects. Some babies may have future problems. This includes the intestine or digestive tract. They can have blockage caused by abnormal intestinal tissue or scar tissue.
How can NEC be prevented?
Based on this theory, several best clinical strategies are being recommended to reduce the risk of NEC. These include breast milk feeding, restrictive use of antibiotics, supplementation with probiotics, and standardized feeding protocols (SFPs).
What causes portal venous gas in neonates ( NEC )?
The commonest cause of portal venous gas in neonates is the passage of small amounts of gas through an umbilical venous catheter in the absence of NEC (,52) (,Fig 4). In NEC, portal venous gas is an extension of intramural gas that enters the veins of the bowel wall and passes into the portal venous system.
How is portal venous gas related to intramural gas?
In NEC, portal venous gas is an extension of intramural gas that enters the veins of the bowel wall and passes into the portal venous system. The amount of portal venous gas is not always related to the amount of intramural gas present, and the portal venous gas may be more obvious than the intramural gas (,48).
What kind of gas is in the portal vein?
Gas in the portal veins usually manifests as an echogenic moving foci in the lumen of the portal vein.
How is portal venous gas characterized in CT?
Similar to X-ray features, portal venous gas manifests on CT as branching gaseous foci of low density in the liver, portal vein and its tributaries. The vessel-gas interface may cause streak artifact. Typically, the gas in the liver is peripheral which helps differentiate it from more central gas due to pneumobilia).
