Gas within the hepatic portal venous system and the bowel wall as shown on abdominal films prompted exploratory laparotomy in a patient who showed no localizing abdominal symptoms or signs. The small bowel was pale but not ne crotic, and the mesenteric vessels were widely patent. Pathologic diagnosis of the resected bowel showed focal mucosal necrosis. This was most likely related to digoxin-induced nonocclusive mesenteric ischemia.
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