How can gas in the portal venous system be differentiated from gas in the biliary tree?
Gas in the portal venous system extends to the periphery of the liver while gas in the biliary tree is limited to the central parts of the liver.
What are the causes of intramural bowel gas in infancy?
Prematurity, necrotizing enterocolitis, hypoplastic left or right heart syndrome, bowel obstruction, Hirschsprung disease and gastrointestinal rotavirus.
What are the imaging modalities of choice for evaluation of children with suspected necrotizing enterocolitis?
Plain abdominal radiography and ultrasonography
Transabdominal ultrasound with high-frequency linear transducer revealed extensive small echogenic foci in the intestinal walls.
Branching echogenic foci also noted in the liver parenchyma extending to the liver edges representing portal venous gas.
Mild to moderate free fluid was detected in the peritoneal cavity. Mural thickening of the rectum.
Conclusion:
- gas in bowel wall with extraluminal fluid
- rectal mural thickening
- portal venous gas
- ascites