Sonographic Detection of Hepatic Portal Venous Gas Originating from Ischemic Bowel Disease: A Case Report and Literature Review

Hepatic portal venous gas is a rare and ominous radiological finding and it is an important diagnostic clue associated with patients who may be harboring an intra-abdominal catastrophe. Hepatic portal venous gas represents a challenge for emergency physicians in terms of diagnosis and management of the underlying cause. The most common and severest precipitating etiology is ischemic bowel disease, which has a mortality rate of 75% to 90%. Herein, we report a case of ischemic bowel disease with rare but typical hepatic portal venous gas by ultrasonography that led us to the identification of ischemic bowel disease.