Abstract
In January 2014, a 75-year-old female who had been diagnosed as having multiple myeloma presented with a sore throat. A plain x-ray of the chest revealed intraperitoneal free air. Abdominal contrast-enhanced CT showed evidence of pneumatosis along a broad extent of the small intestinal wall, and the patient was diagnosed as having pneumatosis cystoides intestinalis. Because she had no abdominal tenderness, conservative treatment was selected. Six days after admission, a repeat contrast-enhanced abdominal CT showed complete disappearance of the intraperitoneal free air and the pneumatosis. She was discharged from the hospital eleven days after admission. In some cases of PCI with intraperitoneal free air, emergency surgery might be required for suspected perforation of the digestive tract. However, in the cases without peritoneal signs, a careful decision should be made about the need for surgery, because the condition is potentially curable by conservative management.
