HEPATIC PORTAL VENOUS GAS AND GASTRIC EMPHYSEMA WITH SURVIVAL

The authors recently examined a 69-year-old man with extensive hepatic portal venous gas and interstitial gastric emphysema secondary to obstruction of an intrathoracic stomach as a result of volvulus and redescent of the fundus. After partial decompression of the distended fundus by nasogastric aspiration, the patient underwent surgical reduction and completely recovered. This case is of interest since it illustrates a previously unreported cause of this venous gas and because it demonstrates that gas in the portal venous system is not necessarily a 'lethal' sign.