Idiopathic Pneumatosis Intestinalis, Radiological and Endoscopic Images

ttp://dx.doi.org/10.1016/j.jpge.2016.01.005 341-4545/© 2016 Sociedade Portuguesa de Gastrenterologia. Published C BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4 istory, diet change, sick contacts, abdominal surgery or astrointestinal diseases. She denied alcohol or tobacco. he was not taking any medication or supplements with he exception of the usual antihypertensive therapy. In the hysical examination she was hemodynamically stable with bdominal distention and mild abdominal pain, but withut peritoneal reaction. Laboratory evaluation was normal s well as gasometric parameters. Abdominal computed omography (CT) evidenced the presence of gas in the bdominal wall, at the level of the transverse and rectumigmoid colon (Fig. 1), with no other changes. Colonoscopy howed small emphysematous formations in the left colon, mptying with pinprick (Fig. 2) confirming pneumatosis ntestinalis (PI). An idiopathic PI was admitted in view of he absence of a secondary cause of PI and endoscopic mages of discrete bubbles of gas instead crescentic or linar gas collections more often associated with secondary I. After low fiber diet, dimethicone, laxatives and two eeks of oral metronidazole the complaints disappeared as ell as PI on abdominal CT three months later. PI is a rare linical entity that can be associated with several diseases ncluding intestinal ischemia and bowel perforation.1 In 15% f the cases is idiopathic, occurring in a benign context1,2 nd medical therapy can induce remission3--5 as illustrated ere.