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Neurofibromatosis with pathologic fracture
Joseph Junewick, MD FACR
over 7 years ago
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Portal Venous Gas

Case Detail

Anatomy: Gastrointestinal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Trauma
Created: over 4 years ago
Updated: 8 months ago
Tags: PEDS
Modality/Study Types: US
Activities:
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History

11 day male with projectile vomiting.


Case Images


Diagnosis

Portal venous gas with pyloric stenosis

Findings

US – Innumerable punctate hyperechogenic foci in portal veins

Discussion

Portal venous gas is typically seen in necrotizing enterocolitis but can be seen in Hirschsprung’s disease, collagen vascular disease, intestinal obstruction and massive bowel dilation. Portal venous gas may be explained in hypertrophic pyloric stenosis by gastric distention and forceful vomiting leading to venolymphatic escape of gastric air. Gas and gas-induced rouleaux formation lead to intraportal hyperechogenicities.

Reference

Sarti J and Kennedy A. Portal venous gas in hypertrophic pyloric stenosis. J Pediatric Surg (2006); 41:1935-1936.



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