Abstract
A 79-year-old woman developed abdominal distention and was admitted. She had a history of cerebral infarction and had a right hemiplegia. She accidentally swallowed a piece of a plastic spoon 7 days prior to admission. Emergency endoscopy was performed, but the plastic piece could not found. It was found in the stool 5 days later. On abdominal X-ray, a huge volume of intra-abdominal free air and an emphysematous bulla in the small intestine were found ; abdominal CT scan confirmed these findings. Although, the inflammatory response and physical findings were inconclusive, we could not rule out the possibility of alimentary tract perforation due to the large volume of abdominal free air. During surgery, intramural emphysema was present in almost all of the small intestine and mesentery, but no site of perforation was found. A diagnosis of pneumatosis cystoides intestinalis was made. The postoperative course was uneventful, and the patient was discharged on the 19th day after the operation.
