Description
A 65-year-old male was found to have hepatic portal venous gas (HPVG) by computed tomogram secondary to ischemic bowel. Despite aggressive surgical and antibiotic treatment, the patient died within 12 hours. Portal pyelophlebitis, when identified by air in the portal venous system, is a grave indicator of ischemic bowel with a very high mortality rate, except in patients with inflammatory bowel disease.