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BACKGROUND Neonatal hepatic portal venous gas (HPVG) is associated with a high risk of necrotizing enterocolitis (NEC) and was previously believed to be associated with an increased risk of surgery. CASE SUMMARY A 3-day-old full-term male infant was admitted to the pediatrics department after presenting with “low blood glucose for 10 min”. Hypoglycemia was corrected by intravenous glucose administration and oral breast milk. On the 3rd d after admission, an ultrasound examination showed gas accumulation in the hepatic portal vein; this increased on the next day. Abdominal vertical radiograph showed intestinal pneumatosis. Routine blood examination showed that the total number of white blood cells was normal, but neutrophilia was related to age. There was a significant increase in C-reactive protein (CRP). The child was diagnosed with neonatal NEC (early-stage). With nil per os, rehydration, parenteral nutritional support, and anti-infection treatment with no sodium, his hepatic portal vein pneumatosis resolved. In addition, routine blood examination and CRP examination showed significant improvement and his symptoms resolved. The patient was given timely refeeding and gradually transitioned to full milk feeding and was subsequently discharged. Follow-up examination after discharge showed that the general condition of the patient was stable. CONCLUSION The presence of HPVG in neonates indicates early NEC. Early active anti-infective treatment is effective in treating NEC, minimizes the risk of severe NEC, and reduces the need for surgery. The findings of this study imply that early examination of the liver by ultrasound in a sick neonate can help with the early diagnosis of conditions such as NEC.

A 15‐year‐old female neutered Domestic Long Hair cat was presented for acute hematemesis. Initial diagnostic workup, including serum biochemistry panel, complete blood count and coagulation profile, was unremarkable. Abdominal ultrasound showed gastric mural thickening and non‐obstructive gastric foreign material. Endoscopy was performed to remove the foreign matter and obtain biopsies. Significant abnormalities of the upper gastrointestinal (GI) tract were not noted endoscopically. Overnight, the patient required a packed red blood cell transfusion following two episodes of severe hematemesis, hypotension and collapse. Serial radiographs and ultrasound revealed hepatic portal venous gas (HPVG). Computed tomography (CT) scan confirmed massive gas accumulation within the liver and emphysematous gastritis. The patient became increasingly unstable and, given her rapid decline, humane euthanasia was elected. Gastric and duodenal histopathology showed inflammatory changes, spirochetosis and mucosal epithelial degeneration. HPVG is a rarely described finding and prognosis varies drastically depending on aetiology. To the best of our knowledge, this is the first description of portal vein gas documented on multiple imaging modalities, including CT, in a cat. The patient in this report had several potential risk factors including prior endoscopy, compromise of the intestinal barrier and evidence of gastric mural bacterial invasion., This report describes a case of hepatic portal venous gas (HPVG) in a feline visualized initially on ultrasound and ultimately confirmed with CT, which is considered the gold‐standard for identification in humans. HPVG is associated with a variety of underlying disease processes, some of which require emergent aggressive intervention and may result in significant mortality. Reports of HPVG in veterinary medicine are sparse.

Hepatic portal venous gas (HPVG) is associated with various fatal conditions requiring urgent surgical intervention. In patients with chronic intestinal pseudoobstruction (CIPO), HPVG results from intestinal dilation. CIPO is a condition that is generally not surgically remediable; however, in emergency cases, an operative approach is often considered to prevent additional complications or to restore intestinal propulsion. However, surgery in these patients is associated with high postoperative morbidity and mortality rates and frequent reoperation. Intestinal resection and adhesion formation can potentially worsen the underlying dysmotility and are associated with refractory postoperative ileus, which often requires reoperation. Here, we present a case of HPVG in a patient with chronic intestinal pseudoobstruction (CIPO), treated conservatively and discuss the management of patients with HPCG.

Hepatic portal venous gas (HPVG) is a rare imaging finding in infants and usually indicative of a severe disease process such as necrotizing enterocolitis, bowel ischemia, or bowel wall rupture / infarction. The diagnosis of HPVG may have serious implications such as parenteral nutrition, antibiotics and even surgery. In this case, we present an 8-week-old male with a history of prematurity presenting with HPVG, later concluded to be caused by milk protein allergy. Milk protein allergy is a rare cause of HPVG, but it should be recognized due to its benignity and potential prevention of unnecessary testing and interventions.

Hepatic portal venous gas (HPVG) refers to the imaging signs formed by the abnormal accumulation of abnormal gas in the portal veins and the branches of the inner veins of the liver due to various reasons, and is usually associated with poor prognosis. HPVG is mostly caused by abdominal diseases. Herein, we reported a patient with hepatocellular carcinoma developed HPVG following transcatheter arterial chemoembolization (TACE). This patient was identified as Barcelona Clinic Liver Cancer (BCLC) stage B, and treated by five times of TACE. Gelfoam sponge was used as embolic agent in the first and last TACE treatment. After the first TACE, pneumonia occurred in the right lung, and pneumorachis with iodine oil deposition occurred in the tumor lesion in the right lobe of the liver, which was considered as hepatic abscess. After three more TACE, enhanced MRI showed significant necrosis and reduction of the lesions. After the fifth TACE, the enhancing computed tomography (CT) showed a large amount of gas in the lesions and in the portal veins, which was considered as HPVG. Although after active treatment, the patient died soon. To our knowledge, this is the first case report of a patient with hepatocellular carcinoma developed HPVG following TACE with gelfoam sponge as embolic agent.

Hepatic portal venous gas and pneumobilia (PB) are uncommon findings, indicating the accumulation of gas in the portal vein and its branches and in the biliary tree, respectively. Aims of this retrospective, descriptive study were to describe the computed tomographic (CT) features and visualization techniques of hepatic portal venous gas (HPVG) and PB in a group of small animal veterinary patients. The CT data of patients with HPVG and PB were retrospectively reviewed. Thin-section multiplanar reformatting and minimum intensity projection (MinIP) views were used to assess the acquired volume dataset. The CT features recorded were as follows: amount, aspect, distribution, and localization of the gas in the liver. Five patients were included (four dogs and one cat), two presenting HPVG and three with PB. Gas in HPVG presented a peripheral location, whereas in PB was characterized by a central location. The aspect of the gas was tubular in case of HPVG and mixed tubular and rounded in PB. An analogous number of animals between the two groups showed comparable amount (mild, moderate, and severe) and distribution (diffuse and focal). Thin-section CT can detect the presence of gas in the liver, and a combination of two-dimensional and thin-slab MinIP can differentiate between HPVG and PB in dogs and cats. The distinctive features are peripheral versus central location and tubular versus rounded aspect of the gas.

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.

Background Hepatic portal venous gas (HPVG) generally indicates poor prognoses in patients with serious intestinal damage. Although surgical removal of the damaged portion is effective, some patients can recover with conservative treatments. Aim To establish an optimal treatment strategy for HPVG, we attempted to generate computed tomography (CT)-based criteria for determining surgical indication, and explored reliable prognostic factors in non-surgical cases. Methods Thirty-four cases of HPVG (patients aged 34-99 years) were included. Necessity for surgery had been determined mainly by CT findings (i.e. free-air, embolism, lack of contrast enhancement of the intestinal wall, and intestinal pneumatosis). The clinical data, including treatment outcomes, were analyzed separately for the surgical cases and non-surgical cases. Results Laparotomy was performed in eight cases (surgical cases). Seven patients (87.5%) survived but one (12.5%) died. In each case, severe intestinal damage was confirmed during surgery, and the necrotic portion, if present, was removed. Non-occlusive mesenteric ischemia was the most common cause (n = 4). Twenty-six cases were treated conservatively (non-surgical cases). Surgical treatments had been required for twelve but were abandoned because of the patients' poor general conditions. Surprisingly, however, three (25%) of the twelve inoperable patients survived. The remaining 14 of the 26 cases were diagnosed originally as being sufficiently cured by conservative treatments, and only one patient (7%) died. Comparative analyses of the fatal (n = 10) and recovery (n = 16) cases revealed that ascites, peritoneal irritation signs, and shock were significantly more frequent in the fatal cases. The mortality was 90% if two or all of these three clinical findings were detected. Conclusion HPVG related to intestinal necrosis requires surgery, and our CT-based criteria are probably useful to determine the surgical indication. In non-surgical cases, ascites, peritoneal irritation signs and shock were closely associated with poor prognoses, and are applicable as predictors of patients' prognoses.

The conventional radiologic method for liver segmentation is based on the position of the hepatic and portal veins. However, during surgery, liver segments are resected based on the distribution of hepatic portal blood flow. This discrepancy can lead to a number of problems, such as miscommunication among clinicians, missing the location of the segment with the hepatic mass, and the risk of extended hepatic resection. We suggest a novel method to determine hepatic segments based on portal blood flow, as in the surgical approach, but by using high and low mechanical indexes in contrast-enhanced ultrasonography with Sonazoid. This approach is helpful for preoperatively determining hepatic segments and reducing the risk of missing the location of a hepatic tumor or extended hepatic resection.

Hepatic portal venous gas is defined as tubular areas with decreased enfeeblement around the periphery of the liver. It is a rare finding and associated with various underlying abdominal pathologies, from benign causes to potentially life threatening conditions. Rate of diagnosis of hepatic portal venous gas have been increased due to widespread use of advanced imaging techniques. Existence of gas in the portal veins after blunt abdominal trauma is a temporary incidental finding that could be resolved spontaneously. Here we report an extremely rare condition that describes a child who was suffering from air emboly of the portal veins due to blunt abdominal trauma. The condition was clinically under control and resolved spontaneously.

This retrospective study aimed to clarify whether the postoperative prognosis differs between right and left hepatectomy for Bismuth type I/II perihilar cholangiocarcinoma. Preoperative images of 195 patients with perihilar cholangiocarcinoma were reexamined. Patients with Bismuth type I/II perihilar cholangiocarcinoma without a difference in extraductal tumor invasion between the right and left sides of the hepatic portal region were classified into those undergoing left (L group) or right (R group) hepatectomy. Twenty-three patients (11.8%) were classified into the L group and 33 (16.9%) into the R group. All eight patients with pTis/1 belonged to the L group. The L group had significantly less liver failure than the R group (p = 0.001). One patient (4.3%) in the L group and four patients (12.1%) in the R group died from postoperative complications. Among 48 patients with pT2, the L group tended to have better overall survival (median, 12.2 vs. 5.6 years; p = 0.072), but not recurrence-free survival (median, 9.1 vs. 3.6 years; p = 0.477), in comparison to the R group. Postoperative survival after left hepatectomy for Bismuth type I/II perihilar cholangiocarcinoma is expected to be as long as that after right hepatectomy.

Hepatic portal venous gas (HPVG) is a rare clinical picture with high mortality. It is characterized by the accumulation of gas in the portal system on radiological examination. We presented a 74-year-old male patient who was followed up due to sigmoid diverticulitis, developed progressive colo venous fistula and HPVG during the follow-up and resulted in death. Diverticulitis is mainly associated with sigmoid diverticulosis. The anti-biotherapy is preferred if there is any contamination in the surrounding adipose tissue or an abscess formed adjacent to the colon wall. However, surgery is required if there is no regression in the follow-up. Colovenous fistula is rarely seen in the etiology of HPVG, but it is among the diagnoses to be kept in mind. The quick diagnosis of disease, the determination of its etiology and the choice of surgical treatment, and the post-operative intervention will decrease the mortality rates associated with the disease.

Portal hypertension in children is not uncommon and extra hepatic portal venous obstruction (EHPVO) constitute about 75% of portal hypertension. Several risk factors predispose to development of EHPVO such as neonatal sepsis, umbilical catheterization, severe dehydration, abdominal trauma or surgery etc. Common presentations are haematemesis and splenomegaly. Acute variceal bleeding is a medical emergency. Liver function is normal in extrahepatic portal hypertension unless there is portal bilopathy. High index of suspicion is the key of early diagnosis. Esophagogastrodudenoscopy is diagnostic for portal hypertension and doppler ultrasonography of portal vein confirm extra hepatic portal venous obstruction (EHPVO) in presence of thrombus and/or cavernoma. Adequate management including endotherapy, pharmacotherapy and/or surgery is an important key for better outcome. Mediscope Vol. 6, No. 2: Jul 2019, Page 79-85

Ultrasonography (US) is believed to be the most available method of detecting hepatic portal venous gas (HPVG) with real-time imaging capability. Hepatic portal venous gas has characteristic image appearances in various ultrasound modes such as bright mode, Doppler mode, and even motion (M) mode. In this article, we give a comprehensive review of the image appearances of HPVG among different modes of US with a special focus on the M mode US. Hepatic portal venous gas was recognized as linear echogenicities in various oblique directions (the meteor shower sign) on the M mode US. This specific sign may expand some potential of HPVG detection by US.

To evaluate role of 3-T magnetic resonance portovenography (MRPV) in children with extra hepatic portal venous obstruction (EHPVO) and compare unenhanced and contrast-enhanced sequences. 20 Children with EHPVO underwent MRPV using unenhanced [T2, T1 pre-contrast, Balanced turbo field echo (BTFE)] and contrast-enhanced (CE) modified DIXON (mDIXON) sequences. The images were evaluated for the patency of abdominal veins, hepatic and splenic parenchyma by two radiologists for interobserver agreement. BTFE and post-contrast mDIXON sequences performed best for evaluation of abdominal veins. Concordance between the BTFE and CE sequences was good to very good for both the radiologists for splenic vein (SV) evaluation. The concordance between the two sequences for evaluation of superior mesenteric vein and its confluence with the SV was less remarkable and varied from fair to good, while the interobserver agreement was very good to perfect. The interobserver agreement between the BTFE and CE sequence for the evaluation of left renal vein was very good, while that for IVC was perfect. The agreement between BTFE and CE sequence was perfect for the evaluation of right and middle hepatic veins, while the interobserver agreement was good to perfect. The interobserver agreement was poor for evaluation of hepatic parenchyma on BTFE sequence as compared to CE sequence, and moderate for splenic parenchyma. BTFE sequence is the single best unenhanced MR pulse sequence to detect all the vascular structures in children with EHPVO. CE-MRI is not superior to BTFE sequence and should be used at the discretion of the radiologist.

BackgroundHepatic portal venous gas (HPVG) is a rare clinical condition that is caused by a variety of underlying diseases. However, the factors that would permit accurate identification of bowel ischemia, requiring surgery, in patients with HPVG have not been fully investigated.MethodsThirty patients that had been diagnosed with HPVG using computed tomography between 2010 and 2019 were allocated to two groups on the basis of clinical and intraoperative findings: those with (Group 1; n = 12 [40%]) and without (Group 2; n = 18 [60%]) bowel ischemia. Eleven patients underwent emergency surgery, and bowel ischemia was identified in eight of these (73%). Four patients in Group 1 were diagnosed with bowel ischemia, but treated palliatively because of their general condition. We compared the characteristics and outcomes of Groups 1 and 2 and identified possible prognostic factors for bowel ischemia.ResultsAt admission, patients in Group 1 more commonly showed the peritoneal irritation sign, had lower base excess, higher lactate, and higher C-reactive protein, and more frequently had comorbid intestinal pneumatosis. Of the eight bowel ischemia surgery patients, four (50%) died, mainly because of anastomotic leak following bowel resection and primary anastomosis (3/4, 75%). All except one patient in Group 2, who presented with aspiration pneumonia, responded better to treatment.ConclusionsEarlier identification and grading of bowel ischemia according to the findings at admission should benefit patients with HPVG by reducing the incidence of unnecessary surgery and increasing the use of safer procedures, such as prophylactic stoma placement.

Objectives The aquarium sign is the name given to a large quantity of bubble-like echoes that suggests the presence of hepatic portal venous gas (HPVG). Few studies in the literature have addressed the relationship between the aquarium sign and HPVG. In some cases, HPVG can only be detected using ultrasonography. HPVG can be observed in a variety of conditions, including those that require emergency surgery, such as acute mesenteric ischaemia (AMI). Therefore, it is important to identify the presence of HPVG as soon as possible. Materials and methods We report a case of the aquarium sign, where bubble-like echoes flowed from the right atrium towards the right ventricle, which was identified using bedside cardiac ultrasonography as part of a point-of-care ultrasound test. Results This aquarium sign finding led to the diagnosis of AMI, which was confirmed using contrast-enhanced computed tomography (CT). Conclusion The aquarium sign is a useful finding suggestive of HPVG and mesenteric ischaemia, which can be rapidly and easily observed using bedside cardiac ultrasonography. However, there are very few reports on the aquarium sign. The inability of other more cumbersome diagnostic imaging modalities, such as CT and magnetic resonance imaging, to detect HPVG emphasizes the utility and convenience of detecting the aquarium sign using bedside ultrasonography. This technique can lead to early detection of life-threatening diseases as well as improve the prognosis for patients. The diagnostic implications of the aquarium sign for HPVG are still unclear and require further research. Learning points The aquarium sign is a characteristic of hepatic portal venous gas (HPVG), which is often observed in acute mesenteric ischaemia (AMI).Owing to the high mortality rate of AMI with HPVG, urgent laparotomy is recommended.Bedside ultrasonography can more rapidly and easily detect HPVG than CT imaging, and with a higher degree of sensitivity.

Hepatic portal venous gas (HPVG) has long been associated with catastrophic intraabdominal conditions. Advancements in ultrasound (US) and computed tomography (CT) imaging have resulted in an increased number of incidental and clinically benign HPVG cases identified. Causes of clinically benign HPVG include viral gastroenteritis, gastritis, pancreatitis, appendicitis and diverticulitis. Our case demonstrates the first reported case of HPVG in an adolescent patient associated with enteropathogenic E. coli (EPEC). The patient's course was favorable, marked by a short stay in the pediatric intensive care unit (ICU) and did not require surgical intervention. With higher sensitivity of imaging modalities to diagnose both suspected and incidental cases of HPVG, clinicians will be required to consider the risks and benefits of conservative treatment or surgical intervention.

Hepatic portal venous gas was found at the abdomen CT of a patient who presented abdomonal pain and ileus in the course of colchine-bortezomib therapy. Drug toxicity was suspected as there was no evidence of intestinal ischemia at laparatomy.

Background The presence of hepatic portal venous gas (HPVG) has been associated with intestinal necrosis and is an indication for surgical intervention. But some cases can be treated conservatively. This study aimed to examine the factors associated with the need for surgical intervention and the development of intestinal necrosis in patients with HPVG.Methods This was a retrospective, multicenter and observational cohort study consisting of 166 patients who were diagnosed as having HPVG based on CT findings between April 2013 and March 2019. The patients were divided into two groups: surgery Required Group and Non-surgery Required Group. We reviewed medical records for clinical backgrounds, vital signs, laboratory data, CT findings, and compared the two groups using the Chi-square test and Student’s t-test with p-values < 0.05 indicating statistical significance.Results There were 72 patients in the Surgery Required Group and 94 in the Non-surgery Required Group. There were no statistically significant differences in age and sex between the two groups. Pulse rate (PR) ( p = 0.004), C-reactive protein (CRP) ( p = 0.012), lactate dehydrogenase (LDH) ( p = 0.006) and abnormality of the white blood cell count (WBC) ( p = 0.012) in the Surgery Required Group were significantly higher than those in the Non-surgery Required Group. The diameter of the superior mesenteric artery (SMA) and vein (SMV), and ratio of SMV/SMA were measured but no statistically significant difference was observed. Band-like pneumatosis ( p < 0.001) and ring like pneumatosis( p < 0.001) were observed with a significantly higher frequency in the Surgery Required Group, but no significant difference was observed in bubble-like pneumatosis. Intrahepatic HPVG was significantly more frequent in the Non-surgery Required Group than surgery Required Group ( p < 0.001), and extrahepatic HPVG ( p < 0.001) was the opposite result. There was no significant difference of HPVG distribution in lobes.Conclusions PR, CRP, LDH, abnormality of WBC, band-like pneumatosis, ring-like pneumatosis, and extrahepatic HPVG are the factors associated with an indication for surgery indication and intestinal necrosis in patients with HPVG.

The paper describes the occurrence of a rare complication - portal and systemic venous air embolism - after endoscopic retrograde cholangiopancreatography, related to the endoscopic procedure. It can be associated with the more frequently encountered post-endoscopic retrograde cholangiopancreatography complications pancreatitis or cholangitis. However, it can also be noted with perforation. The presented case suggests that in the clinical context an early abdominal ultrasound examination confirming hepatic portal venous gas and/or systemic venous air embolism could be useful for the diagnosis of post-endoscopic retrograde cholangiopancreatography retroduodenal perforation, and thus highlights the need for a high index of suspicion should this occurrence be noted post-procedurally, in order to ensure the best care of patients. The paper describes the occurrence of a rare complication – portal and systemic venous air embolism – after endoscopic retrograde cholangiopancreatography, related to the endoscopic procedure. It can be associated with the more frequently encountered post-endoscopic retrograde cholangiopancreatography complications pancreatitis or cholangitis. However, it can also be noted with perforation. The presented case suggests that in the clinical context an early abdominal ultrasound examination confirming hepatic portal venous gas and/or systemic venous air embolism could be useful for the diagnosis of post-endoscopic retrograde cholangiopancreatography retroduodenal perforation, and thus highlights the need for a high index of suspicion should this occurrence be noted post-procedurally, in order to ensure the best care of patients.

The liver is the primary site of metastases in colorectal cancer (CRC) because the majority of the venous mesenteric drainage enters the hepatic portal venous circulation. More than 50% of patients with CRC will develop hepatic metastases over the course of their life. This ultimately leads to death more than two-thirds of these patients (1).

Insulin resistance is an underappreciated facet of type 1 diabetes that occurs with remarkable consistency and considerable magnitude. Although therapeutic innovations are continuing to normalize dysglycemia, a sizable body of data suggests a second metabolic abnormality—iatrogenic hyperinsulinemia—principally drives insulin resistance and its consequences in this population and has not been addressed. We review this evidence to show that injecting insulin into the peripheral circulation bypasses first-pass hepatic insulin clearance, which leads to the unintended metabolic consequence of whole-body insulin resistance. We propose restructuring insulin therapy to restore the physiological insulin balance between the hepatic portal and peripheral circulations and thereby avoid the complications of life-long insulin resistance. As technology rapidly advances and our ability to ensure euglycemia improves, iatrogenic insulin resistance will become the final barrier to overcome to restore normal physiology, health, and life in type 1 diabetes.

Highlights • HPVG is caused by iatrogenic procedures. • The disappearance rate of HPVG is correlated with the severity of the disease. • The patient with chronic bowel ischemic is treated with a comprehensive approach., Introduction Hepatic Portal Venous Gas (HPVG) is a rare pathological condition that may be caused by iatrogenic factors. Case report A 66-year-old Chinese male patient with HPVG underwent laparotomy for chronic bowel ischemia. Transcathete cardiac defibrillator was implanted via left subclavian vein for ventricular tachycardia. Discussion There are many hypotheses about how gas runs through the intestine into the mesenteric portal venous system. HPVG patients can be improved through comprehensive management. Patients with mesenteric ischemia should be observed in hospital and after discharge, and need surgical intervention if chronic bowel ischemia recurs. Conclusion This case proves the usefulness of comprehensive management in treating HPVG. Prognosis of HPVG should consider the pathological changes contributing to HPVG.

In past decades, hepatic portal venous gas (HPVG) has rarely been reported, and the mortality rate has been very high. In most cases, surgical intervention was needed. Presently, abdominal computed tomography can be conveniently used to diagnose HPVG, which has various underlying causes and benign courses. We present the case of a patient with HPVG due to anastomosis leakage after a sigmoidectomy for diverticulitis; the patient was cured with conservative management.

Background Laparoscopic surgery has been gradually promoted by people because of its advantages of small trauma and quick recovery. Methods However, the operation is difficult, the first hepatic portal should be completely fastened during the operation. In this paper, through the study of the existing structure of the blocker, a kind of blood flow blocker for the first hepatic hilum blocking under laparoscope is designed. All kinds of parameters were calibrated through equation calculation, and the pressure guiding the blood flow blocking of hepatic portal during operation was calculated. Results The dynamic analysis was carried out with ANSYS software, and it was found that the fluid movement state was most uniform when the airflow velocity reached 8 m/s. The experimental apparatus was set up to simulate the process of hepatic portal vein being blocked in vitro, then the feasibility of blocking effect was evaluated. Conclusions Finally, it is concluded that the designed blood flow blocking device can have good blocking effect on blood vessels.

We aimed to apply the pediatric abdominal CT protocol of Donnelly et al. in the United States to the pediatric abdominal CT-AEC. Examining CT images of 100 children, we found that the sectional area of the hepatic portal region (y) was strongly correlated with the body weight (x) as follows: y=7.14x + 84.39 (correlation coefficient=0.9574). We scanned an elliptical cone phantom that simulates the human body using a pediatric abdominal CT scanning method of Donnelly et al. in, and measured SD values. We further scanned the same phantom under the settings for adult CT-AEC scan and obtained the relationship between the sectional areas (y) and the SD values. Using these results, we obtained the following preset noise factors for CT-AEC at each body weight range: 6.90 at 4.5-8.9 kg, 8.40 at 9.0-17.9 kg, 8.68 at 18.0-26.9 kg, 9.89 at 27.0-35.9 kg, 12.22 at 36.0-45.0 kg, 13.52 at 45.1-70.0 kg, 15.29 at more than 70 kg. From the relation between age, weight and the distance of liver and tuber ischiadicum of 500 children, we obtained the CTDIvol values and DLP values under the scanning protocol of Donnelly et al. Almost all of DRL from these values turned out to be smaller than the DRL data of IAEA and various countries. Thus, by setting the maximum current values of CT-AEC to be the Donnelly et al.'s age-wise current values, and using our weight-wise noise factors, we think we can perform pediatric abdominal CT-AEC scans that are consistent with the same radiation safety and the image quality as those proposed by Donnelly et al.