Abstract
Hepatic portal venous gas (HPVG) is an infrequent yet potentially life-threatening condition that necessitates prompt diagnosis and effective management. This study presents the clinical scenario of an 88-year-old known diabetic patient, with chronic kidney disease (CKD), stroke, and hypertension, who was brought to the emergency department with symptoms of vomiting, constipation, and abdominal pain. Upon conducting a computed tomography (CT) scan of the abdomen, dilatation of the small bowel and pneumatosis intestinalis in the right abdomen, accompanied by the presence of air within the portal vein, were identified. Subsequently, an emergency laparotomy was performed, which revealed no evidence of ischemia, and the patient was treated with IV antibiotics. This case highlights the significance of adopting a multidisciplinary approach and timely interventions in the management of HPVG. The successful resolution of this complex case underscores the importance of prompt diagnosis, appropriate resuscitation, and surgical intervention, all of which play pivotal roles in enhancing patient outcomes.