Our Summary

This research paper discusses a case of hepatic portal venous gas (HPVG), a condition where gas gets into the liver’s blood vessels. In the past, HPVG was rarely reported and often fatal, usually requiring surgery. Now, it can be easily diagnosed using an abdominal CT scan. The paper presents a patient who developed HPVG after undergoing a specific type of surgery (sigmoidectomy) for a bowel condition (diverticulitis). However, instead of needing further surgery, this patient was successfully treated using non-surgical, ‘conservative’ methods.

FAQs

  1. What is hepatic portal venous gas (HPVG) and how is it diagnosed?
  2. What are some possible causes of HPVG?
  3. What is the typical treatment for HPVG after a sigmoidectomy for diverticulitis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to closely follow post-operative care instructions, including taking prescribed medications, following a proper diet, and attending follow-up appointments. It is important to report any unusual symptoms or complications, such as increased pain, fever, or changes in bowel habits, to your healthcare provider promptly. Compliance with these recommendations can help ensure a successful recovery and minimize the risk of complications.

Suitable For

Patients who may be recommended for sigmoidectomy include those with severe diverticulitis that has not responded to conservative treatment, patients with recurrent diverticulitis, patients with complications such as perforation or obstruction, and patients with a family history of colon cancer or other risk factors for developing colorectal cancer.

Timeline

Before sigmoidectomy:

  • Patient presents with symptoms of diverticulitis, such as abdominal pain, bloating, and changes in bowel habits.
  • Imaging studies, such as a CT scan, may be performed to confirm the diagnosis and assess the severity of the condition.
  • Conservative treatment, such as antibiotics and dietary changes, may be initially recommended to manage diverticulitis symptoms.
  • If conservative treatment is ineffective or if the diverticulitis is severe, a sigmoidectomy may be recommended to remove the affected portion of the colon.

After sigmoidectomy:

  • Following the sigmoidectomy procedure, the patient may experience post-operative pain and discomfort.
  • The patient is closely monitored for any complications, such as anastomosis leakage, which can lead to hepatic portal venous gas (HPVG).
  • If HPVG is suspected, abdominal CT imaging may be performed to confirm the diagnosis.
  • In the case of anastomosis leakage causing HPVG, conservative management may be sufficient to treat the condition, avoiding the need for surgical intervention.
  • The patient is monitored for resolution of symptoms and complications, and follow-up appointments may be scheduled to assess recovery and prevent future occurrences of diverticulitis.

What to Ask Your Doctor

  1. What is a sigmoidectomy and why is it necessary for my condition?
  2. What are the risks and potential complications of a sigmoidectomy?
  3. How will I be monitored for complications after the surgery?
  4. What is hepatic portal venous gas and how is it related to sigmoidectomy?
  5. What is the likelihood of anastomosis leakage after the surgery and how is it treated?
  6. What is the expected recovery time and follow-up care after a sigmoidectomy?
  7. Are there any dietary or lifestyle changes I should make post-surgery?
  8. How will my quality of life be affected after a sigmoidectomy?
  9. Are there any alternative treatment options to consider?
  10. What is the long-term outlook for my condition after a sigmoidectomy?

Reference

Authors: Hong I, Hong SW, Chang YG, Lee B, Lee WY, Ohe HJ, Kim YK. Journal: Ann Coloproctol. 2019 Oct 31;35(5):282-284. doi: 10.3393/ac.2018.03.23.1. Epub 2019 Jan 25. PMID: 30678448