PMC6344922_01
7.4.18: XR abdomen acute complete w/chest: dilated small bowel loops in LUQ, air fluid levels in right mid abdomen, paucity of large bowel gas, suggestive of small bowel obstruction, suggestion of free air.
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Imaging, XR (Fig. 1) and CTAP (Fig. 2), demonstrating SBO with free air concern for perforated viscus.
Multiple air filled cystic serosal nodules consistent with pneumatosis cystoides intestinalis.
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On 7.5.18 the patient underwent exploratory laparotomy and was found to have emphysema of proximal jejunum, and underwent 125 cm resection of jejunum (Figs 3 and 4).
Multiple air filled cystic serosal nodules consistent with pneumatosis cystoides intestinalis.
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On 7.5.18 the patient underwent exploratory laparotomy and was found to have emphysema of proximal jejunum, and underwent 125 cm resection of jejunum (Figs 3 and 4).
7.9.18: CTAP w/IV and PO contrast: pneumatosis within ascending and transverse colon, no evidence of bowel thickening or fat stranding, no evidence of bowel obstruction.
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Due to the concern for potential bleed, on 7.9 the patient had CTAP (Fig. 5) which demonstrated newly developed pneumatosis within ascending and transverse colon.
7.14.18: CTAP w/IV and PO contrast: largely resolved pneumatosis.
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CTAP (Fig. 6) on 7.14.18 demonstrated largely resolved pneumatosis of ascending and transverse colon. 7.17 Mechanical soft diet, discharged home.