Pneumatosis portalis

The radiologic finding of gas within the portal venous system and its intrahepatic branches.

Causes

• Bowel ischemia

• Necrotizing enterocolitis

• Gas-forming bacterial infections

  • Intra-abdominal abscess

  • Diverticulitis

  • Appendicitis

• Inflammatory bowel causes

  • Ulcerative colitis

  • Crohn's disease

  • Severe enterocolitis

• Gastrointestinal obstruction --> bowel distention with mucosal injury

• Iatrogenic causes

  • Endoscopy

  • Colonoscopy

  • Endoscopic retrograde cholangiopancreatography (ERCP)

  • Postoperative gastrointestinal procedures

  • High-pressure mechanical ventilation

• Trauma