Pneumatosis intestinalis

37 Pneumatosis intestinalis



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Fig. 37.1A This patient has extensive air in the bowel wall in the left lower quadrant of the abdomen which is in keeping with pneumatosis intestinalis. The patient had extensive bowel infarction.



Background


Pneumatosis intestinalis refers to air in the bowel wall, caused by ischaemia. Its presence implies impending perforation and it is an emergency. It often occurs in the setting of longstanding intestinal obstruction (see Chapter 30 & 32).


Consider this possibility in any very unwell, obstructed surgical patient. Such patients require a prompt operation. This condition carries a very high mortality rate.



Differential diagnosis


This condition should not be confused with pneumatosis coli, a benign condition caused by gas-filled vesicles in the colonic wall (see Fig. 37.2).


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Fig. 37.2 This patient has pneumatosis coli. There are gas-filled cysts in the left upper quadrant. This is a benign condition. It does not follow the bowel wall. This condition is associated with COPD.

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Aug 20, 2016 | Posted by in ULTRASONOGRAPHY | Comments Off on Pneumatosis intestinalis

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