Diffuse pneumatosis cystoides intestinalis is a relatively uncommon finding and is often asymptomatic. When present, especially to this degree, an underlying cause is often present. This case is very similar to that discussed in the below case report ¹, including the presence of a sigmoid volvulus. Due to the patients repeated bowel resections an intestinal hypermobility resulting in PCI (and the volvulus) is a possibility. 

Small volume pneumoperitoneum is noted in the patient, adjacent to the liver edge. This may be due to 'benign' rupture of one of the cysts, and as such was not noted during laparotomy.

The cause of PCI is debated, with some sources suggesting an association with chronic pulmonary diseases. This patient does appear to have an interstitial fibrosis, likely induced by previous asbestos exposure, as evidenced by the dense pleural plaques - although a separate/concurrent interstitial process cannot be excluded.