Portal venous air is a rare condition whose pathogenesis is not fully understood. It is most commonly caused by mesenteric ischemia but may have a variety of other causes. It is idiopathic in approximately 15% of cases.1 Classically air in the portal vein has been detected by plain radiography but computed tomography and sonography have been shown to be more sensitive instruments in its detection2. We report a case of PV air detected on gray scale sonography that went undetected on CT. The cause of PV air was unknown, however the patient had Pneumococcal Pneumonia.

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