n South African Gastroenterology Review - A case of Pneumatosis Intestinalis and perspectives on the condition in general : case report




In November 2011 a 66-year-old man presented acutely unwell to the surgical team with abdominal pain, back pain and urinary symptoms. His abdomen was tender but not peritonitic with a palpable suprapubic mass. On plain abdominal radiographs he had a segmental large bowel dilatation of the right colon with transition to normal caliber colon at the hepatic flexure. On abdominal CT scan he had a small supra renal aortic arch aneurysm with no evidence of a retroperitoneal leak, a large bladder mass was noted as were three small liver lesions. Though he remained clinically stable his abdominal signs failed to abate and a decision was made to perform a laparotomy. At operation a right hemi colectomy for a non-perforated ischaemic bowel segment was performed and an ileostomy fashioned. One of the liver lesions was biopsied and found to be benign and a transurethral resection of the bladder tumor performed. The bladder histology was that of a non-invasive papillary transitional cell carcinoma. He recovered well. At this juncture his aneurysm was to be monitored only and he was anticoagulated.


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