LAUSR

Highlights • Hepatic Portal Venous Gas (HPVG) is a rare condition often associated with a significant underlying pathologies.• The mechanism underlying the passage of the gas from the intestine into the mesenteric, then portal, venous system is not fully understood.• The high mortality rate made HPVG a cause of mandatory explorative laparotomy throughout the last fifty years of the twentieth century.• The frequent presence of benign conditions underlying this condition has diverted the common therapeutic approach to more cautious options.