Portomesenteric venous gas: imaging findings with an emphasis on sonography.
OBJECTIVE
Portomesenteric venous gas is a rare condition with an unclear pathogenesis. Most studies in the medical literature mention computed tomography (CT) as the primary imaging tool for this entity. The objective of this study was to outline the advantages and disadvantages of sonography in the evaluation of patients with portomesenteric venous gas.


METHODS
We describe 7 patients (3 female and 4 male; age range, 47-83 years) with portomesenteric venous gas. Both CT and sonographic examinations were performed in each patient. Our patient population consisted of 2 patients with superior mesenteric artery occlusion, 3 with ischemia of the colon, small bowel, or both, 1 with gastric ulcer perforation, and 1 with ischemic bowel disease presumably secondary to complications of continuous ambulatory peritoneal dialysis.


RESULTS
Portal venous gas was observed in all 7 patients with sonography and in 6 patients with CT. Computed tomography was unable to show gas in the portal venous system in 1 patient. Sonography showed patchy hepatic gas accumulation (likely within small peripheral portal vein branches) with no correlative findings on CT. Computed tomography showed important associated findings, including pneumatosis intestinalis.


CONCLUSIONS
In cases with portomesenteric gas, CT is the preferred modality for showing the underlying etiology. However, with its real-time imaging capability, sonography may also be a very valuable imaging modality in the evaluation of this entity.
Oktar
Suna Ozhan
SO
Department of Radiology, Gazi University, Ankara, Turkey. sunaoktar@gazi.edu.tr
Karaosmanoğlu
Devrim
D
Yücel
Cem
C
Erbaş
Gonca
G
Ilkme
Aydan
A
Canpolat
Ilksen
I
Ozdemir
Hakan
H
D000368:Aged; D000369:Aged, 80 and over; D004618:Embolism, Air / Q000000981:diagnostic imaging*; D005260:Female; D005740:Gases; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011379:Prognosis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D005740:Gases