Images in Clinical Medicine

Kim Eagle, M.D., Editor

Gas in the Portal Venous System

Leon W. Kundrotas, M.D., Lt. Col., M.C., U.S.A.F., and A. Brian Robinson, M.D., Maj., M.C., U.S.A.F.

N Engl J Med 1996; 335:864September 19, 1996

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Article

Figure 1 A computed tomographic scan of a 73-year-old man with acute epigastric pain and abdominal distention shows gas in the portal venous system (arrows). A plain film of the abdomen did not reveal the gas within the liver. The patient was taken to the operating room, where he was found to have mesenteric ischemia from stenosis of the celiac axis, superior mesenteric artery, and inferior mesenteric artery and a massive infarction of the small bowel. The patient survived a small-bowel resection. C denotes colon; StB, gas in the stomach lumen; St, stomach partially filled with contrast agent; S, spleen; A, aorta; and L, liver.

Kim Eagle, M.D.

Leon W. Kundrotas, M.D., Lt. Col., M.C., U.S.A.F.
A. Brian Robinson, M.D., Maj., M.C., U.S.A.F.
Wilford Hall Medical Center, Lackland AFB, TX 78236-5300