POCUS Finding of Portal Venous Gas: An Unusual Consequence of an Amyloid Dysmotility Related Bezoar. 

 -  2022 
<br/><br/> A 73-year-old male with a recent finding of pericardial effusion and syncope was evaluated with point of care ultrasound for recurrent effusion. A thickened left ventricle and recurrent pericardial effusion were found. Unexpectedly, on scanning the inferior vena cava (IVC), extensive portal venous gas was identified, a finding previously described as a "meteor shower". Subsequent imaging by computed tomography (CT) identified gastric edema and peri-gastric vessel gas as the source of the portal gas, attributed to a large bezoar. The bezoar was later classified as a phytobezoar and the patient was found to have both cardiac and gastrointestinal manifestations of light chain amyloidosis. The gastrointestinal amyloidosis predisposed the patient to bezoar formation owing to associated dysmotility, a rare complication of an unusual manifestation of systemic amyloid. Copyright (c) 2022 Grace B. DeMarco, MD, Qiuchen Jiang, Ernest Fischer. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>2369-8543 
<br/><br/><label>Standard No.: </label>10.24908/pocus.v7i2.15681 [doi] PMC9983721 [pmc] 
<br/><br/><label>Index Terms--Occupation: </label><br/>Internal Medicine Residency<br/>MedStar Georgetown University Hospital/MedStar Washington Hospital Center
<br/><br/><label>Index Terms--Function: </label><br/>Case Reports