Case Report

Published: Dec 15, 2025 | DOI: 10.24911/ejmcr.9-2312

Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report


Authors: Zakariya Sattar orcid logo , Wadah Ali


Article Info

Authors

Zakariya Sattar

Department of General Surgery, The Royal Wolverhampton NHS Trust, Wolverhampton, UK

orcid logo ORCID

Wadah Ali

Consultant Colorectal Surgeon, The Royal Wolverhampton NHS Trust, Wolverhampton, UK

Publication History

Received: July 30, 2025

Accepted: November 13, 2025

Published: December 15, 2025


Abstract


Background:
Pneumatosis portalis and pneumatosis intestinalis, when seen in conjunction, are rare but ominous findings on imaging of the abdomen, frequently indicating severe intra-abdominal disease such as intestinal ischaemia. We present a case of pneumatosis portalis and intestinalis following cardiac surgery without evidence of significant intra-abdominal disease.

Case presentation:
A 62-year-old male underwent open bioprosthetic aortic valve replacement for severe aortic stenosis. Four days post-operatively, the patient developed severe abdominal pain and distension. Contrast computed tomography (CT) of the abdomen demonstrated a significant degree of gas within the portal venous system and within the intestinal wall. At exploratory laparotomy, no evidence of significant bowel ischaemia or intra-abdominal disease was evident, a finding confirmed after re-look laparotomy 48 hours later. The patient was eventually discharged with no further sequelae noted.

Conclusion:
This case demonstrates the often pre-terminal finding of pneumatosis portalis and intestinalis, seen in a patient without evidence of any significant abdominal disease. We report a previously undescribed case of pneumatosis portalis and intestinalis following open cardiac surgery. Exploratory laparotomy should be performed if there is any clinical concern given the potential mortality associated with these findings.


Keywords: pneumatosis portalis; pneumatosis intestinalis; portal venous gas; aortic valve surgery; case report


Pubmed Style

Zakariya Sattar, Wadah Ali. Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report. EJMCR. 2025; 15 (December 2025): -. doi:10.24911/ejmcr.9-2312

Web Style

Zakariya Sattar, Wadah Ali. Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report. https://www.ejmcr.com/index.php/articles/2312 [Access: December 17, 2025]. doi:10.24911/ejmcr.9-2312

AMA (American Medical Association) Style

Zakariya Sattar, Wadah Ali. Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report. EJMCR. 2025; 15 (December 2025): -. doi:10.24911/ejmcr.9-2312

Vancouver/ICMJE Style

Zakariya Sattar, Wadah Ali. Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report. EJMCR. (2025), [cited December 17, 2025]; 15 (December 2025): -. doi:10.24911/ejmcr.9-2312

Harvard Style

Zakariya Sattar, Wadah Ali (2025) Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report. EJMCR, 15 (December 2025): -. doi:10.24911/ejmcr.9-2312

Chicago Style

Zakariya Sattar, Wadah Ali. "Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report." 15 (2025), -. doi:10.24911/ejmcr.9-2312

MLA (The Modern Language Association) Style

Zakariya Sattar, Wadah Ali. "Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report." 15.December 2025 (2025), -. Print. doi:10.24911/ejmcr.9-2312

APA (American Psychological Association) Style

Zakariya Sattar, Wadah Ali (2025) Pneumatosis portalis and pneumatosis intestinalis following aortic valve surgery: a case report. , 15 (December 2025), -. doi:10.24911/ejmcr.9-2312