- Imaging in Intensive Care Medicine
- Published: 19 January 2026
Portal venous gas on point-of-care ultrasound
van Gastel, L., de Kok, L.
Intensive Care Med(2026). https://doi.org/10.1007/s00134-025-08232-1
Abdominal computed tomography (CT) confirmed the presence of portal venous gas and pneumatosis intestinalis in the ileum and ascending colon, with patent mesenteric arteries (Fig. 1, panel A, B and C respectively). Non-occlusive mesenteric ischemia (NOMI) was diagnosed and partial bowel resection was performed. In pneumatosis intestinalis, disrupted mucosa and increased intraluminal pressure allow luminal air to enter capillary veins, draining into the portal vein. Although diagnosing intestinal ischemia in sedated and neuromuscularly relaxed patients can be challenging, the identification of portal venous gas via point-of-care ultrasound by intensive care physicians facilitates prompt diagnosis.
