© 2007 The Authors Journal compilation © 2007 Royal Australian and New Zealand College of Radiologists Australasian Radiology (2007) 51, B137–B139 Case Report Fig. 1. Parasaggital ultrasound image through the liver. Hepatic portal venous gas appears as echogenic foci within the portal vein branches. Under real time imaging, these can be seen to move in a centrifugal direction. Fig. 2. Contrast enhanced axial CT through the right upper quadrant shows extensive portal venous gas adopting its characteristic peripheral distribution within the liver. Fig. 3. Contrast enhanced axial CT demonstrating intramural air in the dependant part of the bowel wall (arrow). Fig. 4. Another image from the CT examination demonstrates the appendicolith in the right iliac fossa (arrow). Note again the gas within the intestinal wall adjacent to the appendicolith.