Hepatic-portal venous gas associated with ileus

Hepatic portal venous gas (HPVG) is an ominous prognostic sign. There are only a few reports of survivors with this entity. More rare are cases where no intra-abdominal abscess, free air, or grossly necrotic bowel exists. This a case report not only of a survivor, but of an unusual etiology that did not require surgical intervention. The inciting factor of HPVG was ileus due to anticholinergic side effects of medications and partial bowel compression from gross bladder distention.