Unusual radiological finding of lethal pneumatosis intestinalis and portomesenteric vein gas

Pneumatosis intestinalis and portomesenteric vein gas are rare and potentially severe radiological findings that occur both in pediatric and adult populations.They actually are radiographic signs of underlying intra-abdominal pathology,abnormality or diagnostic medical interference.If combined with other radiological or clinical signs of intestinal ischemia or sepsis,the prognosis is dismal and urgent laparotomy is mandatory.We report two cases of surgical treatment with ominous outcome in an effort to characterize this finding correctly as an absolute surgical indication or as an additional diagnostic criterion that simply marks a further breakdown of the systems in patients with a long list of severe medical conditions.