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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


46501-Afbeelding1.jpg
Abnormal aspect of the liver


46505-Afbeelding2.jpg
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.


46506-Afbeelding3.jpg
There is peritoneal fluid around the liver


46507-Afbeelding4.jpg
Abnormal bowel loop with air in the bowel wall


46508-Afbeelding5.jpg
Another image of the bowel with air in the wall


46509-Afbeelding6.jpg
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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