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Case 078

Pneumatosis intestinalis

An unusual barium enema

This patient underwent a barium enema examination for abdominal pain. What abnormality is shown on these views?

Findings

There are multiple air filled cysts within the colonic wall.

Diagnosis

Pneumatosis (cystoides) intestinalis

Discussion

This benign condition consists of multiple gas filled submucosal or subserosal cysts. It is usually seen within the colon, hence the alternative name of pneumatosis coli. It is idiopathic, but may be associated with chronic bronchitis and emphysema. It is important because it can be mistaken for multiple colonic polyps. If there is doubt, one of the cardinal signs is the lucency of the gas seen outside the line of the colon wall. The cysts are easily recognised on colonoscopy.

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