Author Affiliations: Department of Pediatrics, Bikur Cholim General Hospital, Jerusalem, Israel (Klar A, Yahya RH); Department of Pediatric Surgery, Hadassah University Hospital, Jerusalem, Israel (Gross E); Ultra Sound Unit, Bikur Cholim General Hospital, Jerusalem, Israel (Akerman Y)

Corresponding Author: Aharon Klar, MD, Department of Pediatrics, Bikur Cholim General Hospital, 3-5 Strauss St., POB 492, Jerusalem, Israel (Tel: 972-2-6464214; Fax: 972-2-6464273; Email: aklar@inter.net.il)

Background: A 1-month-old infant with recurrent vomiting for 2 days was diagnosed with gas in the portal vein. This finding is usually regarded as an ominous sign. 

Methods: Physical examination, plain abdominal X-ray, abdominal ultrasonography and pyloromyotomy were performed.

Results: Hypertrophic pyloric stenosis, gas in the portal vein and sludge in the gallbladder were diagnosed.

Conclusions: The benign course of this patient and the patients reported previously shows that portal gas associated with hypertrophic pyloric stenosis preoperatively may not be an ominous sign and the definite surgical treatment should not be delayed.

Key words: portal vein; venous gas; pyloric stenosis

World J Pediatr 2007;3(4):305-307