A Case of Multiple System Atrophy Showing Portomesenteric Venous Gas with Pneumatosis Intestinalis on Abdominal Computed Tomography Associated with a Cause of Death

: This manuscript describes the first known case of a patient with multiple system atrophy whose parasympathetic dominant disturbance might have been associated with the relative constriction of the superior mesenteric artery, leading to nonocclusive mesenteric ischemia and subsequent portomesenteric venous gas with pneumatosis intestinalis on abdominal computed tomography approaching death.