Computed tomography of pneumatosis intestinalis

Four cases of pneumatosis intestinalis detected by computed tomography (CT) are described. Plain abdominal films obtained on the same day as CT failed to show pneumatosis in three of the four cases. The CT appearances characteristic of pneumatosis intestinalis are cystic, linear, or curvilinear gas collections in the periphery of distended, partly fluid-filled loops of bowel. Two of the four cases had underlying bowel infarction. Evidence of pneumatosis should be carefully looked for in patients with acute abdominal pain referred for CT examination. Computed tomography may be a useful modality for the early diagnosis of bowel ischemia when plain abdominal films are noncontributory.