[An 82 year old patient with severe abdominal pain and air in the portal vein].

An 82 year old male patient presented with acute abdominal pain. Computer tomography revealed portomesenteric vein gas and a paralytic ileus due to an acute mesenteric ischemia. Because of the presence of peritoneal signs immediate surgical exploration was performed. The diagnosis of a non-occlusive mesenteric ischemia with bowel infarction was confirmed during surgery and pathologically. The patient survived without any severe consequences.