Esophageal and gastric pneumatosis, portal venous gas

Case contributed by Dr Michael P Hartung

Presentation

Abdominal pain, elevated lactate.

Patient Data

Age: Adult
Gender: Female

Esophageal and gastric distension with pneumatosis. Dilation of proximal small bowel with wall thickening in the mid-distal small bowel. Left lower quadrant colostomy. Small ascites. Portal venous gas throughout the liver. Hetergeneous perfusion of the liver. Hydropic gallbladder. Small pleural effusions. Bilateral ovarian cysts. Fibroid uterus.

Case Discussion

Esophageal and gastric ischemia resulting in pneumatosis and portal venous gas. There is likely small bowel ischemia as well, which is abnormally thickened. This patient had a history of colorectal cancer on chemotherapy with neutropenia, and unfortunately decompensated and passed shortly after this scan. 

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