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Images in medicine
Air in the portal space: where does it come from?
  1. Ramón Elizondo-Romo1,
  2. Jorge Adrián Nuñez-Zuno1,
  3. Iván Josué Jiménez-González1,
  4. Emiliano Montiel-Nuñez1,
  5. José Víctor Jiménez1,
  6. Diego Luis Carrillo-Pérez2,3
  1. 1 Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  2. 2 Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  3. 3 Escuela de Medicina y Ciencias de la Salud, Instituto Tecnológico y de Estudios Superiores de Monterrey (ITESM), Monterrey, Nuevo León, Mexico
  1. Correspondence to Dr Diego Luis Carrillo-Pérez, Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; djiego51{at}gmail.com

http://dx.doi.org/10.1136/postgradmedj-2018-135845

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    A 34-year-old woman with a history of anorexia nervosa and severe malnutrition (body mass index of 6, weight of 31.7 lbs) was hospitalised for multidisciplinary management. Three weeks after progressive enteral nutrition via nasogastric tube, the patient developed acute intense abdominal pain. CT angiography revealed gastric pneumatosis with submucosal thickening associated with significant intrahepatic portal venous gas, and no evidence of mesenteric ischaemia (figure 1). Endoscopic evaluation showed areas of patchy mucosal …

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    Footnotes

    • Contributors RE-R and JAN-Z wrote the manuscript. EM-N, IJJ-G and JVJ were involved in the care of the patient. DLC-P edited the manuscript and agreed to be the corresponding author.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.