2011 Volume 31 Issue 5 Pages 827-830
We report herein on a 61-year-old male who had been prescribed steroids for amyloidosis over an extended period. A routine chest X-ray showed abdominal free air, and abdominal computed tomography showed not only free air but pneumatosis intestinalis and massive retroperitoneal air. A diagnostic laparoscopy was performed to rule out an acute abdomen which has to be surgically treated. There were no findings of perforation, necrosis or infection. Oxygen inhalation was supplied to the patient under the diagnosis of pneumatosis cystoides intestinalis (PCI). Free air and pneumatosis intestinalis are characteristic signs of acute abdomen. However, a laparotomy is sometimes practiced in cases of PCI due to misdiagnosis or difficulty in diagnosis, even though PCI is generally a nonsurgical disease. Diagnostic laparoscopy is a useful procedure for confirming the differential diagnosis of PCI accompanied with free air.
