Intestinal pneumatosis: differential diagnosis

• Published in: Abdominal imaging Vol. 47; no. 5; pp. 1529 - 1540
• Main Authors: Lassandro, Giulia, Picchi, Stefano Giusto, Romano, Federica, Sica, Giacomo, Lieto, Roberta, Bocchini, Giorgio, Guarino, Salvatore, Lassandro, Francesco
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.05.2022; Springer Nature B.V
• Subjects: Abdomen; Chemotherapy; Computed tomography; Diagnosis; Diagnosis, Differential; Differential diagnosis; Emergency medical services; Gases; Gastroenterology; Gastrointestinal diseases; Hepatology; Humans; Imaging; Imaging techniques; Inflammatory bowel diseases; Intestinal obstruction; Intestine; Intestines; Ischemia; Large intestine; Medical diagnosis; Medicine; Medicine & Public Health; Mesenteric Ischemia; Necrosis; Radiography; Radiology; Small intestine; Special Section: Intestinal ischemia; Tomography; Tomography, X-Ray Computed - methods; Trauma; Emergency radiology; Necrotizing enterocolitis; Pneumatosis; Computed tomography; Pneumatosis cystoides intestinalis; Intestinal ischemia
• ISSN: 2366-0058; 2366-004X; 2366-0058
• DOI: 10.1007/s00261-020-02639-8

Intestinal pneumatosis (IP) is an infrequent radiological sign defined as pathological gas infiltration into the bowel wall. It may be associated to different underlying clinical conditions—inflammatory bowel diseases, malignancies, chemotherapy, infections, immune deficiency status, trauma, intestinal ischemia, and necrosis—that are often related to emergency state and require a prompt diagnosis. All the imaging techniques, especially abdominal radiography and Computed Tomography, could detect the presence of IP and discern the forms related to emergency conditions. The differential diagnosis is essential to start an immediate clinical or surgical management and treatment. The aim of this article is to review the radiological features of IP in different illnesses, with particular attention to differential diagnosis.