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Case Reports in Medicine
Volume 2013 (2013), Article ID 564385, 3 pages
http://dx.doi.org/10.1155/2013/564385
Case Report

The Dilemma of Pneumatosis Intestinalis with Pneumoperitoneum: Nonoperative or Surgical Management—Analysis of a Case

Department of General Surgery, University Hospital of Udine, 33100 Udine, Italy

Received 13 December 2012; Revised 25 February 2013; Accepted 4 March 2013

Academic Editor: Yasuhiko Sugawara

Copyright © 2013 A. Rossetto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pneumatosis intestinalis (PI) is an uncommon condition and can be associated with a wide spectrum of diseases, ranging from life-threatening to innocuous conditions. We report the case of a 46-year-old women coming to our attention for an acute abdominal pain, nausea, vomiting, constipation, and increased inflammatory marks, with a CT showing pneumoperitoneum and pneumatosis intestinalis. The previous diagnosis was advanced neoplasia of unknown origin. Despite the surgical intervention, which excluded an ischemic colitis, the patient died in the early postoperative period. The postmortem diagnosis was carcinoma of thymus gland, and the presence of pneumatosis was put down to metastasis nodes in the pulmonary parenchima. This case demonstrates the wide spectrum of presentation of pneumatosis intestinalis, the importance of a careful radiologic evaluation beside the clinical history, since the identification of correct pathogenesis and treatment can be very difficult.