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