Contributions
zouheir bitar; manuscript preparation, writing , editing, review, and its guarantee.
Mohamed Elsayed Elhabibi; literature search, data acquisition, and help in manuscript preparation
Ossama Sajeh Maadarani; data acquisition, and help in manuscript preparation
Ali Khalifa Albirami; data acquisition, and help in manuscript preparation
Mahmoud Mostafa Elzoueiry; reviewing content in terms of writing principles and help in literature search.
Tamer Mohamed Zaalouk; literature search, data acquisition

Consent

Images are entirely unidentifiable, and consent for publication is obtained.

References
  1. Ori Y, Chagnac A, Schwartz A, et al. Non-occlusive mesenteric ischemia in chronically dialyzed patients: a disease with multiple risk factors. Nephron Clin Pract . 2005;101(2):c87-c93.
  2. Manson W, Mike Hafez N. The rapid assessment of dyspnea with ultrasound: RADiUS. Ultrasound Clinics. 2011 Apr 1;6(2):261.
  3. Bloom R, Lebensart P, Levy P. Survival after ultrasonographic demonstration of portal venous gas due to mesenteric artery occlusion. Postgrad Med J 1990;66:137–9.
  4. Liebman P, Patten M, Manny J, et al. Hepatic-portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg 1978;187:281–7.
  5. Abboud B, Hachem J, Yazbeck T, Doumit C. Hepatic portal venous gas: physiopathology, etiology, prognosis, and treatment. World J Gastroenterol 2009;15:3585–90.
  6. Sellner F, Sobhian B, Baur M, et al. Intermittent hepatic portal vein gas complicating diverticulitis—a case report and literature review. Int J Colorectal Dis 2007;22:1395–9.
  7. Naguib N, Mekhail P, Gupta V, Naguib N, Masoud A. Portal venous gas and pneumatosis intestinalis; radiologic signs with wide range of significance in surgery. Journal of surgical education. 2012 Jan 1;69(1):47-51.
  8. Liebman PR, Patten MT, Manny J, et al. Hepatic-portal venous gas in adults: etiology, pathophysiology and clinical significance. Ann Surg . 1978;187:281-287.
  9. Kung D, Ruan DT, Chan RK, Ericsson ML, Saund MS. Pneumatosis intestinalis and portal venous gas without bowel ischemia in a patient treated with irinotecan and cisplatin. Dig Dis Sci . 2008;53:217-219.
  10. Wiesner W, Mortele KJ, Glickman NJ, Ji H, Ros PR. Pneumatosis intestinalis and portomesentric venous gas in intestinal ischemia: correlation of CT findings with severity of ischemia and clinical outcome. AJR Roentgenol . 2001;177:1319-1323.
  11. Boley SJ, Brandt LJ, Sammartano RJ. History of mesentericischemia. The evolution of a diagnosis and management. SurgClin North Am 1997; 77:275.
  12. Wilcox MG, Howard TJ, Plaskon LA, et al. Current theories of pathogenesis and treatment of nonocclusive mesenteric ischemia. Dig Dis Sci 1995; 40:709.
  13. Acosta S, Ogren M, Sternby NH, et al. Fatal nonocclusivemesenteric ischaemia: population-based incidence and risk
  14. Finucane PM, Arunachalam T, O’Dowd J, Pathy MS. Acute mesenteric infarction in elderly patients. J Am Geriatr Soc 1989;37:355.
Figure 1. Ultrasound image showing hyperechoic dots (arrow) within the liver parenchyma and portal vein representing gas.
Videos 1 and 2. Ultrasound videos. Arrows show moving hyperechoic dots, representing air within the portal vein and liver parenchyma. G: gallbladder, L: liver.
Figure 2. Contrast-enhanced phase multidetector CT axial image shows gas in the intrahepatic portal veins and wall of the stomach (black arrow) as multiple areas of low attenuation.