Intestinal pneumatosis: differential diagnosis

Abdom Radiol (NY). 2022 May;47(5):1529-1540. doi: 10.1007/s00261-020-02639-8. Epub 2020 Jul 31.

Abstract

Intestinal pneumatosis (IP) is an infrequent radiological sign defined as pathological gas infiltration into the bowel wall. It may be associated to different underlying clinical conditions-inflammatory bowel diseases, malignancies, chemotherapy, infections, immune deficiency status, trauma, intestinal ischemia, and necrosis-that are often related to emergency state and require a prompt diagnosis. All the imaging techniques, especially abdominal radiography and Computed Tomography, could detect the presence of IP and discern the forms related to emergency conditions. The differential diagnosis is essential to start an immediate clinical or surgical management and treatment. The aim of this article is to review the radiological features of IP in different illnesses, with particular attention to differential diagnosis.

Keywords: Computed tomography; Emergency radiology; Intestinal ischemia; Necrotizing enterocolitis; Pneumatosis; Pneumatosis cystoides intestinalis.

Publication types

  • Review

MeSH terms

  • Diagnosis, Differential
  • Humans
  • Intestines*
  • Mesenteric Ischemia*
  • Radiography
  • Tomography, X-Ray Computed / methods