Pneumatosis cystoides intestinalis

Gas in bowel wall.

Also known as pneumatosis intestinalis.

A radiographic finding and not a diagnosis.

Varies from a benign process to a fulminant gastrointestinal disease.

Can be seen with chronic obstructive pulmonary disease, connective tissue disease, infectious enteritis, leukemia, amyloidosis, celiac disease, HIV disease, organ transplantation, corticosteroid usage and chemotherapy exposure.

15% of cases are benign idiopathic disease, primary pneumatosis intestinalis, with multiple thin walled cysts in the submucosa or subserosa of the colon.

Primary pneumatosis intestinalis usually without associated symptoms and cysts may be found incidentally on radiographic imaging or endoscopy.

On barium enema studies cysts may protrude into the lumen and mimic polyps or a malignancy.

Secondary forms of Pneumatosis intestinalis is associated with chronic obstructive pulmonary disease and obstructive and necrotic gastrointestinal disease.

85% are secondary pneumatosis intestinalis associated with ischemia with necrotizing enterocolitis, mesenteric vascular disease, trauma, infection, inflammation from inflammatory bowel disease, connective tissue disease, Whipple disease, pulmonary disease and colonic obstruction.

Conservative treatment is often adequate when minimal signs and symptoms of ileum, without evidence of bowel perforation, ischemis or necrosis are found at presentation.

Leave a Reply

Your email address will not be published. Required fields are marked *