How can you differentiate bile duct gas from portal venous gas?
The distribution is affected by the flow direction. Gas in bile flows towards the porta hepatis whereas portal venous gas is transported to small veins in the periphery of the liver. For both, supine position of the patient favours the anterior-most portion of the liver.
Pneumobilia in the left hepatic lobe. Cholecystoduodenal fistula.
1.5 cm calculus in the terminal ileum approximately 5-10 cm from the ileocecal valve. The small bowel loops proximal to this are distended with fluid.
Kidneys, adrenals, spleen and pancreas appear normal.