Abstract
Hepatic portal vein gas (HPVG) is an imaging sign first reported in 1955, which indicates a poor prognosis, with a fatality rate of 75%. Often referred to as the "death eye," more than 100 cases of HPVG have been reported to date. Advances in CT and other imaging techniques, as well as timely detection and early treatment, have reduced the mortality rate to 30%. However, HPVG complicated by intestinal gas accumulation and septic shock suggests intestinal necrosis and potentially fatal outcomes. This case report presents a rare instance of acute ischemic intestinal necrosis caused by alcoholism, resulting in hepatic portal vein gas accumulation. Despite interventions such as cardiopulmonary resuscitation, extracorporeal membrane oxygenation (ECMO), and surgical treatment, the patient unfortunately did not survive. This case report emphasizes the critical need for vigilance regarding the potential risk of severe intestinal necrosis in patients with HPVG.