We read with great interest the article titled, “Successful conservative management of hepatic portal venous gas due to anastomosis leakage after a sigmoidectomy,” written by Hong et al. [1]. The authors affirm that they “were unable to find any cases of hepatic portal venous gas (HPVG) associated with anastomotic leak after a colon resection.”

Last year, our group published a case report and literature review of HPVG [2]. In our case, “a computed tomography scan showed little perianastomotic collections with air-fluid levels and massive hepatic portal venous gas.” Furthermore, in our literature review, we reported a paper that presented a case of HPVG with anastomosis leakage [3]. Other papers we reported presented cases of HPVG due to surgical complications, while not specifying which types [4-7].

We write this letter to specify that the HPVG condition could be associated with anastomotic leakage and the management of this surgical complication should also solve the portal venous gas problem.