Abdomen : Case 10

History :  A 55-year-old female with abdominal pain.

What is the positive finding in the plain abdominal radiograph?

A. Large bowel dilatation

B. Small bowel dilatation

C. Stomach dilatation
D. Negative study

Answer : A. Large bowel dilatation

Additional history : Pain at RLQ on physical examination
What is another abnormality?

A. Free air
B. Retroperitoneum air
C. Air in the bowel wall
D. Aerobilia

Answer : C. Air in the bowel wall or pneumatosis intestinalis

This case show curvilinear gas in the cecal wall

Pneumatosis Intestinalis

• Presence of gas in the bowel wall
• Associated with numerous conditions, ranging from benign to life threatening such as bowel infarction
• Although pneumatosis coli can be seen on abdominal radiographs, CT is the most sensitive imaging test for identification

Abdominal CT images