Hepatic Portovenous Gas in a Young Male

Abstract

Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. Hepatic portal venous gas when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention. We present a case of a 35 year-old male patient with a 12 hour history of generalised abdominal pain, watery diarrhoea and vomiting. He had a background of gout and alcoholism. He had an unmeasurable blood pressure and sinus tachycardia when he was first seen. The patient was stabilized after undergoing vigorous intravenous fluid resuscitation, and he was then sent for a CT scan. A considerable amount of hepatic portovenous gas was seen on the CT scan, coupled with dilated and diffusely aberrant small and large bowel with mucosal enhancement.