Portal venous gas

Case contributed by Dr Tomas Jurevicius

Presentation

Severe abdominal pain, nausea, vomiting, tachycardia and hypotension.

Patient Data

Age: 70 years
X-ray

The left lateral decubitus abdominal radiograph shows branching radiolucent structures within the periphery of the liver -  a sign of portal venous gas. There is mild dilatation of the bowel with multiple gas-fluid levels. No evidence of intraperitoneal free gas.

CT

CTA revealed superior mesenteric artery thrombosis, pneumatosis intestinalis, and portomesenteric venous gas. Hepatic and splenic infarction also noted. A filling defect in the imaged descending thoracic aorta may represent an embolic source.

Case Discussion

CT demonstrated superior mesenteric artery thrombosis, pneumatosis intestinalis and portomesenteric vein gas. Following conservative management the patient died.

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Case information

rID: 43128
Published: 25th Feb 2016
Last edited: 16th Jul 2018
Inclusion in quiz mode: Excluded

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