Cystic or linear collections of gas in subserosal or submucosal layers of GI tract wall
Pneumatosis intestinalis: Most common form of intramural gas, found in small bowel more often than colon
Pneumatosis coli: Rounded collections of gas in distal colonic wall, usually asymptomatic finding
Pneumatosis is descriptive sign, not disease or diagnosis
IMAGING
General Features
Fluoroscopic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Laboratory Findings
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Lassandro G et al: Intestinal pneumatosis: differential diagnosis. Abdom Radiol (NY). ePub, 2020
Spencer K et al: Extensive small bowel pneumatosis and ischemia during dinutuximab therapy for high-risk neuroblastoma. Pediatr Blood Cancer. 67(4):e28147, 2020
Kirmanidis M et al: Extensive colonic pneumatosis in a patient on adjuvant chemotherapy after right colectomy for primary terminal ileum lymphoma: a decision-making process between surgical and non-surgical management. Int J Surg Case Rep. 52:84-8, 2018
Milone M et al: Computed tomography findings of pneumatosis and portomesenteric venous gas in acute bowel ischemia. World J Gastroenterol. 19(39):6579-84, 2013
Zorgdrager M et al: Pneumatosis intestinalis associated with enteral tube feeding. BMJ Case Rep. 2013, 2013
Pickhardt PJ et al: Asymptomatic pneumatosis at CT colonography: a benign self-limited imaging finding distinct from perforation. AJR Am J Roentgenol. 190(2):W112-7, 2008
Saba L et al: Computed tomographic imaging findings of bowel ischemia. J Comput Assist Tomogr. 32(3):329-40, 2008
Kim BN et al: Pneumatosis cystoides coli of the ascending colon: colonoscopic and CT colonographic features. Endoscopy. 39 Suppl 1:E73-4, 2007
Kim KM et al: CT Colonography of pneumatosis cystoides intestinalis. Abdom Imaging. 32(5):602-5, 2007
Mikami S et al: Education and imaging. Gastrointestinal: pneumatosis of the ascending colon. J Gastroenterol Hepatol. 22(5):760, 2007
Romano S et al: Multidetector row computed tomography findings from ischemia to infarction of the large bowel. Eur J Radiol. 61(3):433-41, 2007
Liu KL et al: Gastrointestinal: pneumatosis coli. J Gastroenterol Hepatol. 21(4):772, 2006
Hou SK et al: Hepatic portal venous gas: clinical significance of computed tomography findings. Am J Emerg Med. 22(3):214-8, 2004
Moisidou R et al: Typical CT findings of pneumatosis intestinalis and portal venous air in intestinal necrosis. Dig Surg. 21(3):184, 2004
See C et al: Images in clinical medicine. Pneumatosis intestinalis and portal venous gas. N Engl J Med. 350(4):e3, 2004
Sherman SC et al: Pneumatosis intestinalis and portomesenteric venous gas. J Emerg Med. 26(2):213-5, 2004
Taourel P et al: Cecal pneumatosis in patients with obstructive colon cancer: correlation of CT findings with bowel viability. AJR Am J Roentgenol. 183(6):1667-71, 2004
Kernagis LY et al: Pneumatosis intestinalis in patients with ischemia: correlation of CT findings with viability of the bowel. AJR Am J Roentgenol. 180(3):733-6, 2003
St Peter SD et al: The spectrum of pneumatosis intestinalis. Arch Surg. 138(1):68-75, 2003
SebastiĆ C et al: Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis. Radiographics. 20(5):1213-24; discussion 1224-6, 2000
Pear BL: Pneumatosis intestinalis: a review. Radiology. 207(1):13-9, 1998
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Definitions
Cystic or linear collections of gas in subserosal or submucosal layers of GI tract wall
Pneumatosis intestinalis: Most common form of intramural gas, found in small bowel more often than colon
Pneumatosis coli: Rounded collections of gas in distal colonic wall, usually asymptomatic finding
Pneumatosis is descriptive sign, not disease or diagnosis
IMAGING
General Features
Fluoroscopic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Laboratory Findings
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Lassandro G et al: Intestinal pneumatosis: differential diagnosis. Abdom Radiol (NY). ePub, 2020
Spencer K et al: Extensive small bowel pneumatosis and ischemia during dinutuximab therapy for high-risk neuroblastoma. Pediatr Blood Cancer. 67(4):e28147, 2020
Kirmanidis M et al: Extensive colonic pneumatosis in a patient on adjuvant chemotherapy after right colectomy for primary terminal ileum lymphoma: a decision-making process between surgical and non-surgical management. Int J Surg Case Rep. 52:84-8, 2018
Milone M et al: Computed tomography findings of pneumatosis and portomesenteric venous gas in acute bowel ischemia. World J Gastroenterol. 19(39):6579-84, 2013
Zorgdrager M et al: Pneumatosis intestinalis associated with enteral tube feeding. BMJ Case Rep. 2013, 2013
Pickhardt PJ et al: Asymptomatic pneumatosis at CT colonography: a benign self-limited imaging finding distinct from perforation. AJR Am J Roentgenol. 190(2):W112-7, 2008
Saba L et al: Computed tomographic imaging findings of bowel ischemia. J Comput Assist Tomogr. 32(3):329-40, 2008
Kim BN et al: Pneumatosis cystoides coli of the ascending colon: colonoscopic and CT colonographic features. Endoscopy. 39 Suppl 1:E73-4, 2007
Kim KM et al: CT Colonography of pneumatosis cystoides intestinalis. Abdom Imaging. 32(5):602-5, 2007
Mikami S et al: Education and imaging. Gastrointestinal: pneumatosis of the ascending colon. J Gastroenterol Hepatol. 22(5):760, 2007
Romano S et al: Multidetector row computed tomography findings from ischemia to infarction of the large bowel. Eur J Radiol. 61(3):433-41, 2007
Liu KL et al: Gastrointestinal: pneumatosis coli. J Gastroenterol Hepatol. 21(4):772, 2006
Hou SK et al: Hepatic portal venous gas: clinical significance of computed tomography findings. Am J Emerg Med. 22(3):214-8, 2004
Moisidou R et al: Typical CT findings of pneumatosis intestinalis and portal venous air in intestinal necrosis. Dig Surg. 21(3):184, 2004
See C et al: Images in clinical medicine. Pneumatosis intestinalis and portal venous gas. N Engl J Med. 350(4):e3, 2004
Sherman SC et al: Pneumatosis intestinalis and portomesenteric venous gas. J Emerg Med. 26(2):213-5, 2004
Taourel P et al: Cecal pneumatosis in patients with obstructive colon cancer: correlation of CT findings with bowel viability. AJR Am J Roentgenol. 183(6):1667-71, 2004
Kernagis LY et al: Pneumatosis intestinalis in patients with ischemia: correlation of CT findings with viability of the bowel. AJR Am J Roentgenol. 180(3):733-6, 2003
St Peter SD et al: The spectrum of pneumatosis intestinalis. Arch Surg. 138(1):68-75, 2003
SebastiĆ C et al: Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis. Radiographics. 20(5):1213-24; discussion 1224-6, 2000
Pear BL: Pneumatosis intestinalis: a review. Radiology. 207(1):13-9, 1998
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