ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Gastrointestinal and Hepatic Pharmacology
A Life-Threatening Crisis: The Unique Symphony of Aconitine Poisoning-Induced Cardiac Arrest and Hepatic Portal Venous Gas
Provisionally accepted
- Hubei University of Medicine, Shiyan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction:Hepatic portal venous gas (HPVG) is a rare imaging sign often indicative of severe abdominal pathology. The occurrence of HPVG following resuscitation in patients with cardiac arrest caused by aconitine poisoning is extremely rare, and its underlying pathophysiological mechanism remains unclear. This paper reports a case of HPVG appearing three days after resuscitation from cardiac arrest induced by aconitine poisoning and discusses its potential mechanism. Case Summary:We report a case of a 46-year-old male with cardiac arrest due to aconitine poisoning. On day 3 post-successful resuscitation, the patient developed septic shock. Abdominal contrast-enhanced CT revealed hepatic portal venous gas and pneumatosis intestinalis, suggesting intestinal ischemia. Due to high surgical risk, conservative management was initiated (anti-infection, organ support). The patient's condition improved significantly with treatment, the portal venous gas resolved, and he was discharged after one month of hospitalization, fully recovered with no intestinal dysfunction at the 6-month follow-up. This case suggests that portal venous gas appearing post-cardiac arrest resuscitation, while indicative of severe intestinal ischemia, can still lead to a good outcome with aggressive conservative treatment. Conclusion:This case indicates that HPVG following resuscitation from aconitine poisoning may be a consequence of intestinal ischemia-reperfusion injury. Although HPVG often predicts intestinal necrosis requiring surgery, this case demonstrates that for selected patients where intestinal injury is assessed as potentially reversible and surgical risk is extremely high, conservative treatment can be an alternative to emergency surgery, yielding a favorable outcome. This provides a new perspective for individualized management in extreme critical conditions.
Keywords: aconitine poisoning, Cardiac arrest, Hepatic portal venous gas, Intestinal ischemia, conservative management
Received: 01 Oct 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Wang, Pan, Tao, Zhu and Xianyi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: YANG Xianyi
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.