title: Portal venous air in an adult patient with obstructive small bowel volvulus.
abstract: BACKGROUND
  Diagnosis of small bowel volvulus is frequently delayed often resulting in bowel ischaemia and infarction and impairing clinical outcome. Instant and correct diagnosis and subsequent adequate surgery may improve the outcome.
  
  
  METHODS
  We describe a 19-year-old female with small bowel obstruction due to volvulus in whom the diagnosis was suspected based on the finding of air in the bowel wall and in the portal vein on a plain abdominal radiograph.
  
  
  CONCLUSIONS
  Air, present in the portal vein and bowel wall on a plain abdominal X-ray, suggests bowel ischaemia or necrosis and that the need for laparotomy is urgent.
authors.affiliation: Department of Surgery, University Medical Centre Nijmegen, The Netherlands. E.Tan@heel.azn.nl
authors.forename: Edward C T H
authors.initials: EC
authors.lastname: Tan
authors.forename: Gerit J
authors.initials: GJ
authors.lastname: Jager
authors.forename: Wim A
authors.initials: WA
authors.lastname: Bleeker
authors.forename: Harry
authors.initials: H
authors.lastname: Van Goor
mesh_terms: D000006:Abdomen, Acute / Q000000981:diagnostic imaging / Q000601:surgery; D015746:Abdominal Pain / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D000714:Anastomosis, Surgical; D003422:Critical Care; D004618:Embolism, Air / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D007813:Laparotomy / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011859:Radiography; D018570:Risk Assessment; D016896:Treatment Outcome