Gas in the portal system in a patient with an irreversible bowel ischaemia: a case report

The presence of gas in the portal system is an ominous radiological sign. We report a 63-year-old male patient presented on 27th of March 2003 with acute peritonitis secondary to acute irreversible intestinal ischemia caused by acute thrombosis of the superior mesenteric artery. Abdominal computerized tomography scans showed hepatic portal venous gas. The etiology, imaging features and clinical significance of hepatic portal venous gas are discussed. The computerized tomography scan signs of strangulation include thickening of the bowel wall, pneumatosis intestinalis, and portal venous gas