Imaging revealed cardiomegaly (Figure 2a), a large pericardial effusion and pneumatosis
intestinalis of the ascending colon (Figure 2b), and global cardiomyopathy with an ejection fraction of 25% to 30% (Figures 2c, 2d).
Clinically significant pneumatosis
intestinalis with postoperative enteral feedings by needle catheter jejunostomy: an unusual complication.
1) Intramural pneumatosis
and emphysematous gastritis have been reported in association with gastric bezoars.
A keen search is advised when assessing for the signal void of gas, as can be seen in the setting of pneumatosis
or free air; extraluminal gas is more difficult to identify on MR compared to CT.
The air may enter the retroperitoneum via a mesenteric route, via direct perforation or even via pneumatosis
cystoides coli; then it may dissect along structures passing into the periphery including the great vessels and psoas muscle as in our case.
Intestinal and colorectal pathology is more variable and may include pseudomembranes, perforations, toxic megacolon, pneumatosis
intestinalis, and obstructive inflammatory masses.
Upon receipt of a verbal report from the radiologist that the CT scan showed extensive pneumatosis
, small bowel ileus, air in the portal venous system and mild hydronephrosis, Dr.
Subsequent abdominal radiographs documented the presence of the jejunal atresia and pneumatosis
intestinalis (PI), together with air in both the porta hepatis and liver parenchyma (Figs 1-3).
It has been reported to mimic the appearance of colonic polyps (19) (pseudopolyposis medicamentosus); a false positive result on barium enema study, and cystic pneumatosis
intestinalis, (20) where crepitus from palpation of the anterior abdominal wall originated not from pneumatosis
but from palpation of numerous shells rubbing against each other ("colonic crunch").
The Colon Had an "Air" About It: A Case of Symptomatic Pneumatosis
A computed tomography (CT) scan of the abdomen and pelvis (Figures 1 and 2) demonstrated intra- and extrahepatic biliary dilatation secondary to an obstructive process and duodenal and gastric wall thickening with pneumatosis
involving the stomach and most of the duodenum.
detection of gastric pneumatosis
and pneumoperitoneum, suggestive of necrosis and perforation, respectively