ArticleTranslational pediatrics2026
Ultrasound-based nomogram for predicting high-risk hepatic portal venous gas in children: a retrospective cohort study.
Article in Translational pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hepatic portal venous gas (HPVG) is an uncommon but potentially life-threatening ultrasonographic finding in the pediatric population. Early identification of high-risk HPVG cases requiring urgent surgical intervention remains a clinical challenge. This study aimed to develop and validate an ultrasound-based nomogram for predicting high-risk HPVG in children. Methods: A retrospective cohort of 107 pediatric patients with ultrasound-confirmed HPVG was analyzed. Participants were divided into high-risk group (n=20) and benign group (n=87) based on whether they underwent abdominal surgery or died. Clinical characteristics and ultrasound features were compared between groups. Univariate and multivariate logistic regression analyses were performed to identify independent predictors. A nomogram was subsequently constructed, with model performance assessed via receiver operating characteristic (ROC) curves, calibration curves, the Hosmer-Lemeshow goodness-of-fit test, bootstrap internal validation, and decision curve analysis (DCA). Results: Multivariate logistic regression identified bowel wall layer [unclear vs. clear: odds ratio (OR) =25.171, 95% confidence interval (CI): 4.249-227.708, P=0.001] and intestinal gas distribution (localized Conclusions: This study developed and validated an ultrasound-based prediction model for identifying high-risk HPVG in children. Loss of bowel wall stratification and abnormal intestinal gas distribution were identified as independent predictors of adverse outcomes. This model provides a practical, point-of-care risk stratification tool that can assist physicians in distinguishing children with HPVG who may benefit from urgent surgical intervention from those who can be managed conservatively.
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