An 80-year-old man with a history of chronic obstructive pulmonary disease (COPD) had a chest X-ray done in the course of a workup for congestive heart failure. The upright chest film showed a significant pneumoperitoneum. Surgical consult was called and the abdominal findings were benign, labs were normal, and the patient was asymptomatic.
Abdominal CT scan showed pneumatosis along the transverse colon (yellow arrow), its mesentery, and in the mesentery around the superior mesenteric artery (white arrow). The patient was observed and remained asymptomatic. The discharge diagnosis was pneumatosis cystoides intestinalis (see discussion.)
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A 46-year-old man presented with right lower quadrant pain. Physical findings were minimal and labs were normal. CT scan was done to rule out appendicitis. The only finding was air in the wall of the third portion of the duodenum.
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