Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2020; 8(17): 3804-3807
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3804
Portal gas in neonates; is it always surgical? A case report
Tariq Ibrahim Altokhais
Tariq Ibrahim Altokhais, Division of Pediatric Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 4545, Saudi Arabia
Author contributions: Altokhais TI wrote the whole case report, submitted the manuscript, and submitted the revised the manuscript.
Informed consent statement: Written informed consent was obtained from the mother.
Conflict-of-interest statement: The author has no conflicts of interest relevant to this article to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tariq Ibrahim Altokhais, MBBS, MD, Associate Professor, Surgeon, Division of Pediatric Surgery, Department of Surgery, College of Medicine, King Saud University, PO Box 145111, Riyadh 4545, Saudi Arabia. taltokhais@ksu.edu.sa
Received: May 14, 2020
Peer-review started: May 14, 2020
First decision: July 25, 2020
Revised: July 29, 2020
Accepted: August 14, 2020
Article in press: August 14, 2020
Published online: September 6, 2020
Abstract
BACKGROUND

Hepatic portal venous gas in infants is frequently due to late presentation of necrotizing enterocolitis which is considered a relative indicator for surgical intervention.

CASE SUMMARY

A preterm baby underwent an umbilical catheter placement and discovered in abdominal radiograph to have air in the portal venous system due to malpositioning of the umbilical catheter.

CONCLUSION

Hepatic portal venous gas in infants without signs of necrotizing enterocolitis could result from malposition of umbilical venous catheter, and in that case, should be managed medically, with no need for surgical intervention.

Keywords: Portal gas, Neonate, Necrotizing, Enterocolitis, Umbilical, Case report, Catheter

Core tip: This is a case report of a rare case of a preterm baby with air in the portal venous system due to malpositioning of an umbilical catheter rather than necrotizing enterocolitis. Air in the portal venous system is very important in neonates, as it represents a late sign of necrotizing enterocolitis, and it is considered a relative indicator for surgical intervention. The aim of this case report is to deliver a massage to pediatric surgeons and neonatologists to be aware of this finding and not to rush for surgical intervention.