Presentation
D1 post laparotomy for cecal volvulus with increased pain and rising lactate.
Patient Data
Age: 70 years
Gender: Female
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Extensive small bowel loop dilatation with pneumatosis intestinalis throughout. There is evidence of gas extending into the superior mesenteric vein branches, although no portal venous gas.
additionally there is free gas adjacent to the anastomosis site in the right iliac fossa with no surrounding collection.
Case Discussion
Intramural and portal venous gas has many differentials in the context of recent surgery concerning for bowel ischemia, however can be a benign post operative finding.