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August 18, 2008, Vol 143, No. 8 >
Special Feature | August 18, 2008

Image of the Month—Quiz Case FREE

Daniel Kaufman, MD; Kuang H. Kang, MD; Alexander Schwartzman, MD
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Section Editor: Carl E. Bredenberg, MD

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Arch Surg. 2008;143(8):803. doi:10.1001/archsurg.143.8.803.
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A 77-year-old woman with hypertension, diabetes mellitus, end-stage renal disease, and hypothyroidism presented with nausea, vomiting, constipation, and obstipation of 1 day's duration. Her surgical history was significant for appendectomy, open cholecystectomy, and cesarean delivery. Physical examination revealed a moderately distended, soft, and mildly tender abdomen, and laboratory values showed mild leukocytosis. Computed tomography (CT) revealed distended loops of small bowel and gas in the mesenteric (Figure 1) and intrahepatic portal (Figure 2) veins.

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Figure 1.

Abdominal computed tomography showing streaks of air in the bowel mesentery.

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Figure 2.

Abdominal computed tomography showing arborizing streaks of air in the liver.

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WHAT IS THE DIAGNOSIS?

A. Benign portal venous gas

B. Acute mesenteric ischemia

C. Schistosomiasis

D. Portal pyelophlebitis

Answer

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Figure 1.

Abdominal computed tomography showing streaks of air in the bowel mesentery.

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Figure 2.

Abdominal computed tomography showing arborizing streaks of air in the liver.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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Special Feature
Image of the Month—Diagnosis
Arch Surg. 2008;143(8):804. doi:10.1001/archsurg.143.8.804.
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