Portomesenteric venous gas and pneumatosis intestinalis secondary to mesenteric ischaemia

James Vassallo (Corresponding Author), Julia Gauci, Kelvin Cortis

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We describe a case of a 61-year-old Caucasian man who presented to the emergency department because of severe periumbilical pain associated with nausea and vomiting. On examination, there was gross distension with generalised tenderness, more prominent in the left iliac fossa. The patient was afebrile and parameters were stable.

Coronal and axial CT images showed extensive branching radiolucency extending to within 2 cm of the liver capsule, which is characteristic of portal venous gas (PVG) and differentiates it from pneumobilia (figure 1). Gas was also present throughout the superior mesenteric vein and its tributaries (closed arrow, figure 2B). A large portion of the small bowel wall showed band-like intramural gas (open arrow figure 2A), in keeping with pneumatosis intestinalis (PI).
Original languageEnglish
Article numberbcr2016215977
Number of pages2
JournalBMJ Case Reports
Early online date13 Jul 2016
Publication statusPublished - 2016


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