Extensive pneumatosis coli, acute pancreatitis

Case contributed by Michael P Hartung


Abdominal pain.

Patient Data

Age: 45 years
Gender: Male

Hepatic steatosis. 

Normal caliber enhancing (inflamed) common bile duct. 

Normal enhancing pancreas. Peripancreatic fluid and stranding. Organizing collection inferior the uncinate process, possibly the sequelae of subacute pancreatitis. 

Splenic and portal vein patent. 

Pneumatosis of the entire colon to the level of the anal canal. Small foci of extraluminal air, greatest along the posterior ascending colon. 

Limited abdominal radiograph for gastric tube placement, showing corresponding x-ray appearance of colonic pneumatosis. 

Case Discussion

Benign pneumatosis of the entire colon presumably due to acute pancreatitis. 

Cause of pancreatitis was hypertriglyceridemia, which was treated with urgent plasmapheresis. 

Pneumatosis can be benign or life-threatening. Pancreatitis is uncommonly associated with colonic pneumatosis. Other more common benign intestinal causes include obstruction, enteritis, peptic ulcers, inflammatory bowel disease, collagen vascular disease, and diverticulitis1

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