Abstract
We herein report an unusual case of pneumatosis cystoides intestinalis (PCI) associated with Pneumoperitoneum, induced by an intestinal volvulus. A 90-year-old woman was admitted to our hospital with abdominal pain and muscle guarding. Abdominal X-rays showed enlarged intestines and small bubbles throughout the entire abdomen. Abdominal computed tomography showed free air, enlarged intestines, and widespread gas within the wall of the ileum. Although her radiographic findings were compatible with PCI, surgery was employed because the free air suggested the presence of intestinal perforation. Intraoperative findings revealed a volvulus of the ileum and small subserosal bubbles in the ileum and mesenterium. After the intestinal volvulus was reduced, the small bubbles in her abdominal X-rays, signs of PCI, spontaneously disappeared over the next five days. In general, PCI itself does not require surgery. However, in cases of PCI associated with complications such as intestinal obstruction or peritonitis, surgical treatment is mandatory.
