A rare case of transient portal venous gas

Hepatic portal venous gas, while a rare finding with a classically poor prognosis, is not always fatal. Mortality varies depending on the underlying etiology; bowel ischemia carries the highest mortality rate. Other etiologies include gastrointestinal obstruction, gastric ulcer, infectious processes (intraperitoneal abscess and gastroenteritis), inflammatory processes (ulcerative colitis, Crohn disease, chemotherapy-induced), and complications from endoscopic procedures. We report a case of a 68-year-old woman who presented with a week-long history of diminished intake, nausea, and vomiting, with unremarkable abdominal examination, who was found to have significant portal venous gas that completely resolved within 16 hours without surgical intervention.