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Portal venous gas is a severe and life-threatening sign since it is associated with an overall mortality rate ranging from 75% to more than 90% in instances due to noniatrogenic causes, but its mechanism is still not fully understood. However, after blunt abdominal trauma, portal venous gas is found even if only rarely. Because of developments and improvements in diagnostic procedures, especially computed tomography and ultrasonography, portal venous gas and intestinal pnuematosis can detected, and treated early, and a recent study reported mortality rates as low as 29%. Therefore, in the emergency department, the emergency physician must pay attention to portal venous gas in patients with blunt abdominal trauma. Delay in diagnosis and treatment may lead to intra-abdominal catastrophe, sepsis, and increased mortality. We report a case of portal venous gas and intestinal pnematosis after blunt abdominal trauma.