Portomesenteric venous gas in acute small bowel infarction associated with acalculous gangrenous cholecystitis.

摘要

Hepatic portal venous gas (HPVG), an ominous radiologic sign, was first described by Wolf and Evans in 1955 in infants with necrotizing enterocolitis [1-5]. The mechanism inducing this gas in the portal vein is not well understood. It has numerous causes, predominantly mesenteric infarction, which is associated with poor prognosis [3,5]. Abdominal computed tomography (CT) has become the key imaging procedure used to diagnose acute bowel ischemia and to detect faint signs of portomesenteric venous gas [6-9]. The radiologic presentation has some particularities that physicians must be aware of to avoid delaying treatment. We report a case of extensive portomesenteric gas due to acute small bowel infarction associated with acalculous gangrenous cholecystitis and discuss the pathogenesis and radiologic presentation of this rare entity.