Esophageal and gastric pneumatosis, portal venous gas

Diagnosis certain

Citation, DOI, disclosures and case data

Citation:

Hartung M, Esophageal and gastric pneumatosis, portal venous gas. Case study, Radiopaedia.org (Accessed on 24 Mar 2023) https://doi.org/10.53347/rID-93811

DOI:

https://doi.org/10.53347/rID-93811

Permalink:

https://radiopaedia.org/cases/93811

rID:

93811

Disclosures:

At the time the case was submitted for publication Michael P Hartung had no recorded disclosures.

View Michael P Hartung's current disclosures

Case published:

6 Oct 2021

Revisions:

2 times, by 2 contributors - see full revision history and disclosures

Systems:

Gastrointestinal

Institution:

University of Wisconsin - Madison

Quiz mode:

Included

Presentation

Abdominal pain, elevated lactate.

Patient Data

Age: Adult

Gender: Female

From the case: Esophageal and gastric pneumatosis, portal venous gas

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Axial C+ portal venous phase

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.