Presentation
Severe abdominal pain, nausea, vomiting, tachycardia and hypotension.
Patient Data
The left lateral decubitus abdominal radiograph shows branching radiolucent structures within the periphery of the liver - a sign of portal venous gas. There is mild dilatation of the bowel with multiple gas-fluid levels. No evidence of intraperitoneal free gas.
CTA revealed superior mesenteric artery thrombosis, pneumatosis intestinalis, and portomesenteric venous gas. Hepatic and splenic infarction also noted. A filling defect in the imaged descending thoracic aorta may represent an embolic source.
Case Discussion
CT demonstrated superior mesenteric artery thrombosis, pneumatosis intestinalis and portomesenteric vein gas. Following conservative management, the patient died.
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