Clinical phenotypes and imaging evolution of hepatic portal venous gas under conservative management: a single-center case series using albumin and procalcitonin as prognostic stratification anchors - Summary - MDSpire
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Clinical phenotypes and imaging evolution of hepatic portal venous gas under conservative management: a single-center case series using albumin and procalcitonin as prognostic stratification anchors
To characterize the clinical features, etiologies, imaging patterns, and prognostic factors of hepatic portal venous gas (HPVG) managed conservatively, highlighting its clinical significance.
Key Findings:
Major etiologies of HPVG included intra-abdominal infection (31.3%), gastrointestinal bleeding (25%), intestinal obstruction (18.8%), and perforation (12.5%).
In-hospital mortality rate was 62.5%, indicating a significant risk associated with HPVG.
Non-survivors had significantly lower serum albumin and higher procalcitonin levels.
Interpretation:
Hypoalbuminemia and elevated procalcitonin were strongly associated with mortality in conservatively treated HPVG, consistent with previous findings. Imaging follow-up showed complete gas resolution in several patients after managing the underlying disease.
Limitations:
Small sample size of 16 patients.
Retrospective design may limit generalizability and introduce biases.
Conclusion:
Combined evaluation of imaging dynamics and biomarkers may aid in early risk stratification and guide individualized management, emphasizing the need for further multicenter prospective studies.
