Computerized tomography detection of portal vein air accumulation in severe gastroenteritis during chemotherapy

Portal venous gas is caused by various pathological processes, both iatrogenic (complications of endoscopy) and non-iatrogenic (bowel ischemia, obstruction, perforated gastric ulcer, septicaemia). We report an immunocompromised patient suffering from metastatic cancer of the breast who developed severe gastroenteritis. Plain radiographs of the abdomen showed branching tubular lucencies that extended from the porta hepatis widely over the liver. A computed tomography performed to exclude air in the biliary tract demonstrated portal venous gas. Although the finding of portal venous gas has been associated with a high mortality rate and usually necessitates surgery, our patient survived without surgical intervention.