A rare case of segmental small bowel pneumatosis intestinalis: A case report

Abstract

Introduction: Pneumatosis intestinalis is a rare condition affecting 0.03% of the population. It has a myriad of aetiological causes and hence presentation can vary immensely. The management of symptomatic pneumatosis intestinalis in an acute and outpatient setting remains a challenge to both physicians and surgeons.

Case presentation: We present a case of a 79 year old who presented in a gastroenterology outpatients department with a history suggestive of intermittent small bowel obstruction associated with abdominal pain aggravated by eating and posture. He was found to have signs suggestive of Marfan's syndrome. Computed tomography demonstrated extensive pneumatosis intestinalis of the small bowel. Due to deterioration in symptoms, an exploratory laparotomy was performed demonstrating segmental small bowel pneumatosis intestinalis secondary to a hypermobile mesentery.

Conclusion: This case highlights the importance of both surgical and gastroenterology expertise in successfully managing symptomatic pneumatosis intestinalis.

Keywords: Marfan's; Pneumatosis intestinalis; Small bowel.

Fig. 1

Erect chest radiograph demonstrating free air under both hemidiaphragms.

Fig. 2

Axial computed tomography demonstrating extensive pneumatosis intestinalis of small bowel and free intra-peritoneal air.

Fig. 3

Segmental pneumatosis intestinalis of the small bowel.