Sonography of pneumatosis cystoides intestinalis

Pneumatosis cystoides intestinalis (PCI) is a relatively rare benign condition, and its sonographic findings have rarely been reported. We report on four cases of PCI in which sonography showed multiple immobile linear or spotty high echoes in the thickened colonic wall. These sonographic findings were more clearly visualized by using high-frequency probes and helped in establishing the diagnosis. In addition, color Doppler sonography confirmed the absence of portal gas and helped rule out fulminant PCI. When encountering patients with abundant abdominal gas, the possibility of PCI should be considered and the colonic wall and the portal vein should be meticulously observed by high-frequency probe and color Doppler sonography to prevent a delay in the diagnosis and to improve patient management.