What question did this study set out to answer?

This case aims to illustrate the rare misdiagnosis of pneumatosis cystoides intestinalis as pneumoperitoneum due to trauma.

April 1, 2026Open Access

Pneumatosis cystoides intestinalis misdiagnosed as pneumoperitoneum due to colon perforation in a patient with blunt trauma injuries: a case report

Key Points

This case aims to illustrate the rare misdiagnosis of pneumatosis cystoides intestinalis as pneumoperitoneum due to trauma.
Performed laparotomy based on initial CT findings of suspected pneumoperitoneum.
Conducted a histopathological examination post-surgery.
Analyzed imaging studies to differentiate between PCI and bowel perforation.
CT showed multiple air foci, suggesting pneumoperitoneum but consistent with PCI.
No signs of intraoperative peritonitis were identified.
Histopathology confirmed the diagnosis of pneumatosis cystoides intestinalis.

Abstract

A laparotomy is usually performed when pneumoperitoneum is identified on abdominal computed tomography (CT) in patients with trauma-related injuries. However, in rare cases, pneumatosis cystoides intestinalis (PCI) may be misinterpreted as free air due to bowel perforation. PCI typically follows a benign course and can be managed with physical examinations and imaging studies. In this case, however, the patient was comatose from a severe traumatic brain injury, rendering the physical examination unreliable. Abdominal CT revealed multiple extraluminal air foci in the retroperitoneal space surrounding the ascending colon, consistent with pneumoperitoneum. No evidence of intraoperative peritonitis was found. Nevertheless, because bowel perforation could not be definitively excluded, a right hemicolectomy was performed, and histopathological examination confirmed PCI.

Bookmark

View Full Paper