Published: 2021-07-28

Spontaneous pneumoperitoneum secondary to intestinal pneumatosis: an uncommon cause of acute abdomen

Jonathan Salgado Vives, Enrique Chávez Serna, Fernando Uraik Hernandez Bustos, Guadalupe Grisel Yañez Herrera


Intestinal pneumatosis is a rare entity characterized by gas accumulation in the submucosa and or subserosa of the intestinal tract wall and is generally associated with other diseases, the primary presentation is rare. Most of the cases are asymptomatic, being infrequent the presentation as an acute abdomen secondary to a spontaneous pneumoperitoneum. We report the case of a patient with systemic sclerosis, who presented to the emergency department with abdominal pain and intestinal obstruction, without improvement to conservative treatment and with progression to acute abdomen, for which surgical treatment was performed showing intestinal pneumatosis that compromised the entire small intestine.


Intestinal pneumatosis, Pneumoperitoneum, Acute abdomen, Systemic sclerosis

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Kaya B, Celik K, Karip AB, Altun H, Ozbay ON, Bat O, Memişoglu K. Pneumatosis cystoides intestinalis mimicking acute abdomen. Turk J Gastroenterol. 2014;25(4):426-8.

Ling F, Guo D, Zhu L. Pneumatosis cystoides intestinalis: a case report and literature review. BMC Gastroenterol. 2019;19(1):176.

Feuerstein JD, White N, Berzin TM. Pneumatosis intestinalis with a focus on hyperbaric oxygen therapy. Mayo Clin Proc. 2014;89(5):697-703.

Khalil PN, Huber WS, Ladurner R, Kleespies A, Siebeck M, Mutschler W, et al. Natural history, clinical pattern, and surgical considerations of pneumatosis intestinalis. Eur J Med Res. 2009;14(6):231-9.

Peraza Casajús JM, Fernández F, Iglesias M, Montoro S, Borobia L. Spontaneous pneumoperitoneum secondary to intestinal cystic pneumatosis. Cir Esp. 2009;86(2):113-4.

Balciscueta CI, Álvarez MD, Blanco GFJ. Intestinal pneumatosis. An uncommon cause of acute abdomen. Gastroenterol Hepatol. 2019;42(9):557-8.

Rodríguez JJ, Utrillas MAC, Antón BJS, Moreno OAA, Val JMD. Neumatosis quística intestinal: reporte de un caso. Cir Cir. 2018;86(4):370-3.

Greenstein AJ, Nguyen SQ, Berlin A, Corona J, Lee J, Wong E, Factor SH, et al. Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. J Gastrointest Surg. 2007;11(10):1268-74.

Senosiain C, Crespo L, Maroto M, García-Sánchez MC. Neumatosis intestinal [Pneumatosis intestinalis]. Med Clin (Barc). 2014 May 20;142(10):e19.

Munive AF, Barreto ZR. Pneumatosis cystoides intestinalis. Rev Esp Enferm Dig. 2017;109(1):61.

Wayne E, Ough M, Wu A, Liao J, Andresen KJ, Kuehn D, et al. Management algorithm for pneumatosis intestinalis and portal venous gas: treatment and outcome of 88 consecutive cases. J Gastrointest Surg. 2010;14(3):437-48.