CT Abdomen and pelvis
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CT demonstrates extensive small bowel dilatation, absent mural enhancement with prominent mural gas seen best in the jejunum. The ascending colon appears thick-walled, up to the proximal transverse colon. Gas is also seen in the branches of the superior mesenteric vein, and peripherally in the liver. A small amount of free peritoneal fluid is present.
There is evidence of prior pancreatic surgery with a mass seen in the surgical bed, encasing and occluding the superior mesenteric artery.
Cholecystectomy noted. A normal portal vein cannot be identified; instead a leash of vessels are present at the porta hepatis.