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Related Experiment Video

Updated: Jul 6, 2026

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
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An avoidable abdominal surgery: pneumatosis coli.

Bor-Hen Wu1, Chien-Chih Chen, Tzong-Luen Wang

  • 1Emergency Department, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan.

The American Journal of Emergency Medicine
|April 16, 2008
PubMed
Summary

Pneumatosis coli (PC) is a condition where air is present in the colon wall. This case highlights that surgery for PC is reserved for severe complications, with conservative treatment being the primary approach.

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Area of Science:

  • Gastroenterology
  • Abdominal Imaging
  • Surgical Gastroenterology

Background:

  • Pneumatosis coli (PC) is a rare condition characterized by the presence of gas within the bowel wall.
  • It can mimic more serious conditions like ischemic bowel disease, necessitating careful diagnostic evaluation.
  • Prompt diagnosis and appropriate management are crucial for patient outcomes.

Observation:

  • A 90-year-old male presented with a week of constipation and two days of abdominal fullness.
  • Abdominal radiography revealed intramural air in the colon, indicative of pneumatosis coli.
  • An exploratory laparotomy was performed due to suspicion of ischemic bowel disease.

Findings:

  • The exploratory laparotomy found no evidence of bowel perforation or ischemia.
  • Surgical intervention for pneumatosis coli is typically reserved for cases with complications such as perforation, peritonitis, abscess, or ischemia.
  • Conservative management is the mainstay for most patients diagnosed with pneumatosis coli.

Implications:

  • This case underscores the importance of differentiating pneumatosis coli from acute surgical emergencies.
  • Conservative management, including oxygen therapy and antibiotics, is often sufficient for uncomplicated pneumatosis coli.
  • Further research into the optimal management strategies for various presentations of pneumatosis coli is warranted.