796 Chronic Pneumoperitoneum: Cause or Consequence of Pneumatosis Cystoides Intestinalis

Abstract Pneumatosis cystoides intestinalis (PCI), ‘gas cysts’ in the wall of bowel, is a rare sign that can be found as result many different conditions, ranging from benign and asymptomatic, to life threatening. Its pathogenesis not yet fully understood, patients have PCI are treated heterogeneous manner. Pneumoperitoneum, however, much more commonly seen by General Surgeons, most often occurs perforated viscus; usually necessitating an emergent surgical intervention. Spontaneous pneumoperitoneum very rarely, although it frequently with small bowel PCI, compared large PCI. We present here unusual case patient acute-on-chronic subsequently subacute obstruction associated pneumatosis intestinalis. The also had extensive pan colonic jejunal diverticulosis, area perforation was discrete located mid-ileum. It unclear whether chronic secondary or if developed ileum unknown origin (fitting bacterial mechanical theory pathogenesis). went onto emergency laparotomy resection 28 months after initial presentation trial conservative management.