PMC5019915_01
A chest radiograph demonstrating pneumoperitoneum in the subdiaphragmatic regions bilaterally (arrows). A plain abdominal radiograph showing several dilated loops of small intestine (arrowheads).
CRIGM2016-2474515.001.jpg
PMC5019915_01_CRIGM2016-2474515.001.jpg
fig1
A plain abdominal radiograph showed free air under the diaphragm bilaterally and small bowel dilatation (Figure 1).
An abdominal computed tomography image demonstrating a large quantity of free air in the abdominal cavity (arrows). Multiple small cysts are seen within the wall of the small bowel (arrowheads), consistent with pneumatosis cystoides intestinalis in this patient with systemic sclerosis.
CRIGM2016-2474515.002.jpg
PMC5019915_01_CRIGM2016-2474515.002.jpg
fig2
Abdominal CT scan revealed massive free air and dilated small intestine with gas inside the bowel wall; however, there was no radiological evidence of a localized point of bowel obstruction and no apparent life-threatening acute causes of PCI (Figure 2).