A case of portomesenteric venous gas found with extensive secondary pneumatosis intestinalis in the small bowel, stomach and distal oesophagus on radiographic images with an insidious presentation.

Portomesenteric gas together with pneumatosis intestinalis is a rare radiological finding and is usually associated with bowel ischaemia, extensive bowel necrosis and a high mortality rate. We report a case of portomesenteric venous gas found with extensive secondary pneumatosis intestinalis in the small bowel, stomach and distal oesophagus on radiographic images with an insidious presentation. Here we review the case and discuss the pathophysiology, diagnosis and management of portomesenteric gas associated with bowel ischaemia.