Pneumatosis Intestinalis

Definition

Pneumatosis intestinalis (PI) refers to the presence of gas within the wall of the intestines, specifically in the mucosa or submucosa of the gastrointestinal tract. It is a radiological finding rather than a disease itself and can be benign or life-threatening, depending on the underlying cause.

Pathophysiology

Gas enters the bowel wall through mucosal disruption, bacterial gas production, or increased intraluminal pressure.
It can be classified into:
1. Primary (Idiopathic) Pneumatosis – Rare, benign, and usually asymptomatic.
2. Secondary Pneumatosis – Associated with serious conditions like mesenteric ischemia, bowel obstruction, necrotizing enterocolitis, or infections.

Key Imaging Features

CT scan: Shows linear, cystic, or bubbly gas patterns within the bowel wall.
X-ray: May show radiolucent areas in the bowel wall.

Clinical Significance

Benign cases: May resolve with conservative treatment (e.g., antibiotics, oxygen therapy).
Serious cases: If associated with peritonitis, bowel ischemia, or sepsis, urgent surgery may be required.