Portal pneumatosis in a patient with severe Salmonella colitis

A 65-year-old patient with a history of ischemic stroke, residual ophthalmoparesis, positive fecal occult blood screening and pending colonoscopy attended the Emergency Room due to three days with pain, abdominal distension and diarrhea. In the Emergency Room, he presented diffuse abdominal pain, hemodynamic instability with acute renal failure and metabolic acidosis, with severe elevation of acute phase reactants. Abdominal fluid resuscitation and computed tomography (CT) were performed, which reported a dilatation of the loops of the small intestine to the distal ileum with thickening of the wall of the right colon and gas, dissecting intrahepatic portal branches and splanchnic veins.