We report the case of a 87-year-old woman admitted to our Emergency Department for mild abdominal pain associated with vomiting. An abdominal X-ray showed gas present in the portal venules of the left hepatic lobe, a finding associated with numerous surgical and medical conditions. The patient was successfully managed with conservative treatment. Isolated intrahepatic gas is a rare radiologic finding; emergency surgery should be performed only when there are signs of associated acute intestinal infarction.
Keywords: Emergency surgery; Hepatic portal venous gas (HPVG); Intestinal ischemia; Intrahepatic pneumatosis; Superior mesenteric artery embolism.
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