SMV Gas / Caecal Ischaemia

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60 year old male presents with acute abdominal pain and hypotension. CT Abdomen demonstrates gas within the superior mesenteric venous system. Bowel wall intramural gas is seen predominantly in the caecum and filling the ileo-colic vein. No definite arterial thrombosis is demonstrated. The patient proceeded to the operating theatre where the caecum was found to be ischaemic and dusky. A right hemicolectomy was performed and the patient was admitted to ICU post-operatively.

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