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Case of the Month

November 2012

Patient Data: 26 year old female patient. The same patient from the case of october 2012.

Clinical Info: Patient operated for a duodenal perforation a few days before. She has a distended abdomen and severe abdominal pain

Abnormal aspect of the liver

Another image of the abnormal liver

46502-7563000_20120508__0005.swf The hyperechoic structures are moving. Can you guess what it is

46503-7563000_20120508__0003.swf Detail of the portal vein

46504-7563000_20120508__0002.swf Another detail of the portal vein. There is a massive amount of air in the portal circulation.

There is peritoneal fluid around the liver

Abnormal bowel loop with air in the bowel wall

Another image of the bowel with air in the wall

There is also air in the peritoneal cavity (pneumoperitoneum)

46527-abdom_comp.swf CT

46528-abdom_comp2.swf CT

46530-abdom_comp3.swf CT

The patient was immediately operated and had an abdominal compartment syndrome. Part of the small bowel was necrotic and was removed

For more examples of air in the portal veins see

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