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Fig. 3 | BMC Surgery

Fig. 3

From: Clinical features of patients with hepatic portal venous gas

Fig. 3

Representative case with hepatic portal venous gas. A 70–80-year-old thin patient, who had experienced multiple system atrophy, associated with poor Eastern Cooperative Oncology Group performance status, presented to the emergency department complaining of abdominal distension and nausea. An abdominal CT performed on admission revealed diffuse distension of the small intestine, a suspicion of pneumatosis in the terminal ileum (a arrow), and portal (b, c arrow) and mesenteric venous gas (C, arrowhead). Given the absence of solid evidence of bowel obstruction and ischemia (lack of the peritoneal irrigation sign, a base excess of − 1.6 mmol/L, and a lactate concentration of 2.7 mmol/L), it was decided to treat her with fasting and antibiotics. Following radiological confirmation of significant improvement in the ileal pneumatosis and portal and mesenteric venous gas on the third day following admission, she was discharged in a satisfactory condition after 4 weeks of conservative therapy

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