Recurrent benign pneumoperitoneum - pneumatosis coli

Case contributed by Dr Chris O'Donnell

Presentation

Recurrent episodes of spontaneous pneumoperitoneum. Nil found at surgery apart from an unusual hepatic flexure.

Patient Data

Age: 85 years
Gender: Male

Free intra-peritoneal gas with extensive gas bubbles in the wall of the hepatic flexure (sitting between the right hemidiaphragm and liver)

Case Discussion

Pneumatosis coli is rare, idiopathic and usually benign especially if the gas adopts bubbles (ie cystoides) rather than lines.  These gas cysts can rupture and cause repeated episodes of pneumoperitoneum without peritonitis as there is no spill of bowel content.  In this case the surgeon eventually resected the right colon to prevent further episodes.

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Case information

rID: 39707
Published: 22nd Sep 2015
Last edited: 25th Sep 2019
Inclusion in quiz mode: Included

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