Pneumatosis intestinalis: An important radiological clue in a case of missed perforated appendicitis
Khairul Najmi Muhammad Nawawi1, Azlan Helmy Abd Samat2, Nik Farhan Nik Fuad3
1Department of Medicine, Gastroenterology Unit,The National University of Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia.
Abstract:
Pneumatosis intestinalis (PI) is a rare radiological finding, characterized by the presence of gas in the bowel wall. It has a wide spectrum of possible underlying diagnosis ranging from benign to life-threatening conditions. We present a case of a previously healthy male who was initially presented with missed diagnosis of acute appendicitis which had led to perforated appendix. Failure to recognize the significance of PI and its correlation with other clinical information had caused the delay in his surgical intervention. Fortunately, the patient made a steady recovery and was discharged well. It is important to have a high clinical suspicion of life-threatening conditions whenever patients presented with a radiological clue of PI. Failure to incorporate this finding with other clinical clues might lead to devastating consequences and delay the necessary treatment.
Insights
Pneumatosis intestinalis (PI), a rare finding of gas in the bowel wall, can indicate serious conditions. Prompt recognition of PI alongside clinical signs is crucial for timely surgical intervention and improved patient outcomes.
Area of Science:
- Gastroenterology
- Radiology
- Surgical Pathology
Background:
- Pneumatosis intestinalis (PI) is a radiological sign indicating gas within the intestinal wall.
- It is associated with a broad range of pathologies, from benign to critical, life-threatening conditions.
- Early and accurate diagnosis is essential for appropriate patient management.
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