Hepatic portal venous gas on postmortem CT scan

We report on two cases involving hepatic portal venous gas (HPVG) imaging by computed tomography (CT) scans performed shortly after death. One case involved a 9-month-old infant who died of heat stroke, while the other was a 28-year-old man who died of myocarditis. Although both of these two cases were remarkable distension of the gastrointestinal tract with gas, the autopsies were unable to uncover any clinical cause for HPVG, such as necrotic bowel, ulcerative colitis, intra-abdominal abscess, bowel obstruction, or gastric ulcer. The cause of HPVG in our case is not due to organic disease, but due to gastro-intestinal distention due to emergency management using bag-valve-masking or esophageal tracheal combitube, thereby differing from the mechanisms underlying so-called clinical HPVG.