Detection of Portal Venous Gas by Ultrasonography after Liver Transplantation: A Possible Early Sign of Bacterial Translocation


This Portal venous gas (PVG) is usually associated with intra-abdominal catastrophe. However, there are some reports regarding benign causes of PVG, including the cases related to organ transplantation. We present 3 cases with PVG undergoing living donor liver transplantation (LDLT). All cases simultaneously demonstrated intra-abdominal complications and revealed a bacterial blood culture. We successfully managed all cases with immediate intervention for the possible occurrence of bacterial translocation. Our experience indicates that the detection of PVG by USG is an alarming finding, as a possible early sign of bacterial translocation after liver transplantation. When PVG is detected by USG, it is important to pay prompt attention to bacterial translocation.

Share and Cite:

Shigeta, T. , Sakamoto, S. , Nosaka, S. , Fukuda, A. , Kanazawa, H. , Uchida, H. , Hamano, I. and Kasahara, M. (2012) Detection of Portal Venous Gas by Ultrasonography after Liver Transplantation: A Possible Early Sign of Bacterial Translocation. Open Journal of Organ Transplant Surgery, 2, 14-17. doi: 10.4236/ojots.2012.23004.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] P. R. Liebman, M. T. Pattern, J. R. Benfield, et al., “Hepaticportal Venous Gas in Adults: Etiology, Pathophysiology, and Clinical Significance,” Annals of Surgery, Vol. 187, No. 3, 1978, pp. 281-287. doi:10.1097/00000658-197803000-00012
[2] C. Sebastià, S. Quiroga, E. Espin, et al., “Portomesenteric Vein Gas: Pathologic Mechanisms, CT Findings, and Prognosis,” Radiographics, Vol. 20, No. 5, 2000, pp. 1213-1224.
[3] J. P. Waymack, I. Penn, M. R. First, et al., “Portal Vein Gas and Sepsis after Administration of OKT3,” Lancet, Vol. 329, No. 8539, 1987, p. 984. doi:10.1016/S0140-6736(87)90338-2
[4] M. A. Wallot, J. Klepper, P. Clapuyt, et al., “Repeated Detection of Gas in the Portal Vein after Liver Transplantation: A Sign of EBV-Associated Post-Transplant Lymphoproliferation?” Pediatric Transplantation, Vol. 6, No. 4, 2002, pp. 332-336. doi:10.1034/j.1399-3046.2002.02001.x
[5] J. L. Chezmar, R. C. Nelson and M. E. Bernardino, “Portal Venous Gas after Hepatic Transplantation: Sonographic Detection and Clinical Significance,” American Journal of Roentgenology, Vol. 153, No. 6, 1989, pp. 12031205.
[6] M. Lafortune, B. C. Trinh, P. N. Burns, et al., “Air in the Portal Vein: Sonographic and Doppler Manifestations,’’ Radiology, Vol. 180, No. 3, 1991, pp. 667-670.
[7] S. M. Lichtman, “Bacterial Translocation in Humans,” Journal of Pediatric Gastroenterology and Nutrition, Vol. 33, No. 1, 2001, pp. 1-10. doi:10.1097/00005176-200107000-00001
[8] K. Madsen, “Probiotics in Critically Ill Patients,” Journal of Clinical Gastroenterology, Vol. 42, 2008, pp. S116S118. doi:10.1097/MCG.0b013e31817283cb

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.