Portal vein gas (PVG) is an abnormal accumulation of gas within the portal and intrahepatic portal veins. It is associated with various abdominal diseases, ranging from benign conditions to life-threatening ones that require immediate surgical intervention. Coronary angiography is the standard diagnostic procedure for coronary artery disease. There were no prior reports are available of PVG as a complication of coronary angiography.

In the specific case described here, the patient did not show signs of peritoneal irritation; however, computed tomography scans findings revealed pneumatosis in the wall of the small intestine, hepatic portal vein, and mesenteric vein, along with acute enteritis (etiology pending classification). A cesarean section was not performed, and the patient received treatment with fasting, rehydration, and anti-infection therapy. Subsequently, the patient's symptoms of abdominal distension and pain improved, and follow-up computed tomography scans indicated resolution of the portal system pneumatosis and intestinal wall edema, resulting in a favorable clinical outcome.

Portal venous gas complication following coronary angiography was a complication of coronary angiography.

A 73-year-old man with severe intellectual disability, malnutrition, and hypoalbuminemia presented to our hospital after experiencing vomiting following dinner. Electrocardiography revealed a sinus rhythm. Plain abdominal radiography showed branching radiolucency in the liver. Abdominal computed tomography (CT) revealed branching gaseous foci of low density in the portal vein and its tributaries, suggesting the presence of hepatic portal venous gas (HPVG). Abdominal contrast-enhanced CT showed a segmental lack of contrast enhancement in the intestinal wall despite the absence of vascular occlusion in the main trunk and branches of the mesenteric artery. The patient was diagnosed with non-occlusive mesenteric ischemia (NOMI) accompanied by HPVG. Peripheral parenteral nutrition, antibiotic treatment, and human serum albumin were administered. The HPVG disappeared approximately 20 h after hospitalization. Intravascular dehydration associated with hypoalbuminemia was considered to be the cause of NOMI; the latter improved through the early correction of dehydration and hypoalbuminemia. The presence of HPVG is usually considered a diagnostic clue in patients with abdominal catastrophe and is associated with high mortality. However, the current case demonstrates the pitfalls of assessing the severity of the underlying condition based solely on the presence of HPVG.