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Case of the Week 360




What's the most likely diagnosis?

  • 83 year-old with abdominal pain and sepsis



Conventional radiograph of abdomen

  1. Gallstone ileus
  2. Necrotic uterine fibroid
  3. Portal venous gas
  4. Sigmoid volvulus
  5. Free air

Additional Image - Right upper quadrant close-up

 

Additional Image

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Right upper quadrant-close-up

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Answer:

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3. Portal Venous Gas

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More (Click Discussion Tab)


Portal Venous Gas

General Considerations

  • Initially associated with bowel necrosis and death, portal venous gas is now being imaged in many benign conditions
  • Pathophysiologically, thought to be due to some combination of
    • Bowel distension
    • Damage to mucosa
    • Intra-abdominal sepsis

    More ...


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    is an award-winning educational website aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of cases, quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, GU cardiac, bone and neuroradiology.