Pneumatosis Intestinalis

History: A 47-year-old male had sudden onset of massive bloody stool with negative result study of colon and stomach.

[[{"type":"media","view_mode":"media_crop","fid":"12072","attributes":{"alt":"","class":"media-image","id":"media_crop_7759062683732","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"279","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":" ","typeof":"foaf:Image"}}]]

[[{"type":"media","view_mode":"media_crop","fid":"12073","attributes":{"alt":"","class":"media-image","id":"media_crop_4834020666897","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"280","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","title":" ","typeof":"foaf:Image"}}]]

Diagnosis: Pneumatosis intestinalis after ulcer bleeding embolization control with glue

Urgent angiography showed ulcer bleeding over jejenum portion. He received endovascular embolization with microcoil at proximal branches and distal supers-elective gluing control as patient presented with unstable vital signs on table.

In follow up, his clinical symptoms were gradually improved but plain film suggested impending perforation pneumotosis intestinalis features.

Conservative fasting observation for three weeks, patient discharged without segmental resection surgical treatment. The second follow up KUB revealed less swelling bowel and decreased lipiodol deposition agents amount.

Ming-Chen Paul Shih, MD
Department of Medical Imaging
Kaohsiung Hsio-Kang Municipal Hospital
Taiwan R.O.C