Does cholecystectomy cause pneumobilia?

There have been numerous reports of pneumobilia caused by blunt abdominal trauma with an intact sphincter of Oddi [7-13]. More benign causes of pneumobilia are post-cholecystectomy, post ERCP, or following percutaneous transhepatic cholangiography (PTC) [14,15].

What is portal venous 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 pneumobilia?

Pneumobilia, or air within the biliary tree of the liver, suggests an abnormal communication between the biliary tract and the intestines, or infection by gas-forming bacteria.

How long does pneumobilia last after ERCP?

After ERCP the presence of air in the biliary tree is an expected, common finding. Intra- and extrahepatic pneumobilia is visible in the majority of patients studied with CT within a few weeks from the procedure and may persist for months or years in patients who underwent sphincterotomy (Fig. 2).

Is pneumobilia curable?

While mortality risk of pneumobilia is lower than that of portal venous gas, in such conditions the patient should be operated, because chance of cure is quite high.

What are symptoms of pneumobilia?

Interestingly, the symptoms of gastric outlet obstruction are often unspecific, with epigastric pain, nausea, vomiting and subileus [5,6,7]. Sometimes fever, gastrointestinal bleeding and rarely icterus or signs of cholecystitis occur [8,9].

Is portal venous gas life threatening?

HPVG has been reported with increasing frequency in medical literature and usually accompanies severe or lethal conditions. The diagnosis of HPVG is usually made by plain abdominal radiography, sonography, color Doppler flow imaging or computed tomography (CT) scan.

What causes portal venous 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%).

How is pneumobilia treated?

The treatment is surgical, especially in cases with no prior interventions to the biliary system. The development of pneumobilia is quite rare after blunt trauma. Therefore, both the diagnosis and management are challenging for surgeons.

Is pneumobilia life threatening?

Pneumobilia is defined as the presence of gas in the biliary tree of the liver. Its presence suggests an abnormal communication between the biliary tract and adjacent organs, commonly the gastrointestinal tract. Pneumobilia may reflect a benign incidental finding or herald a life-threatening disease state.

What causes portal venous air?

Air in the portal vein has many causes including Necrotizing entero-colitis, Inflammatory bowel disease, Pneumatosis intestinalis, Mesenteric ischemia, Perforated peptic ulcer, Trauma etc. Explanation: Pneumobilia means air in the biliary tree.

What condition must be excluded when portal venous air is detected?

In a critically ill patient, serious abdominal conditions that can lead to hepatic-portal venous gas have to be excluded before attributing it to iatrogenic complication, and they are summarized in Table 1 [7, 8]. Contrast-enhanced abdominal imaging helped us rule out most of the serious conditions.

What is the difference between Pneumobilia and portal venous gas?

Pneumobilia and portal venous gas are two causes of an intrahepatic branching gas pattern. The two have different causes and implications and need to be distinguished on imaging, and a simple mnemonic can help. A simple mnemonic for remembering the difference in appearance is: portal venous gas: peripheral.

What’s the difference between aerobilia and Pneumobilia?

Pneumobilia, also known as aerobilia, is the accumulation of gas in the biliary tree. It is important to distinguish pneumobilia from portal venous gas, the other type of branching hepatic gas. There are many causes of pneumobilia and clinical context is often important to distinguish between these 3. Article: Pathology.

What does Pneumobilia mean on a CT scan?

Pneumobilia, or air within the biliary tree of the liver, suggests an abnormal communication between the biliary tract and the intestines, or infection by gas-forming bacteria. Pneumobilia usually can be distinguished from air in the portal venous system by its appearance on computed tomography (CT) scan.

Which is more central portal venous system or biliary tree?

Gas within the biliary tree tends to be more central, whereas gas within the portal venous system tends to be peripheral (carried along by the blood). Also, biliary gas is anti-dependent, and typically fills the left lobe of the liver.