Pneumatosis intestinalis, air within the bowel wall, continues to have an elusive etiology due to its varied clinical presentation and associated disease processes. Pneumatosis may be an incidental finding on a routine CT Scan or it could present as peritonitis with intra-abdominal free air. The pathogenesis, therefore, is likely to be multifactorial rather than directly related to one particular, inciting pathology. Here we present a case of a 73-year-old male scheduled for a non-emergent incisional hernia repair who was found to have peritoneal free air without physical exam findings of peritonitis. This unusual case illustrates a rare presentation of small bowel, omental, and abdominal wall pneumatosis. The objective of this presentation is to broaden the clinician’s understanding of pneumatosis intestinalis, including a recommendation to discern the underlying illness as emergent or benign. Finally, we make the case for clinical intuition and the physical exam.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-1314 |
| Date | 12 April 2019 |
| Creators | Carey, Andrew J, Garner, Joseph, Guarderas, Mateo, MD, Vance, John, DO, Floresguerra, Carlos, MD |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Source | Appalachian Student Research Forum |
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