Presentation
Lung transplant (1 year ago) patient with persistent fever and inflammatory lab tests while taking antibiotics. Mild abdominal discomfort.
Patient Data
Presence of gas (air) in the colonic wall and especially in the mesenteric veins of the colonic hepatic flexure. No other abnormal findings (e.g. absence of fat infiltration, wall thickening, and dilatation).
Follow-up Lung CT (one month later) study partially visualizes the colonic hepatic flexure demonstrating regression of the pneumatosis intestinalis.
Case Discussion
This case demonstrates findings consistent with pneumatosis intestinalis as an isolated finding. Given that the patient has almost no abdominal symptoms and the absence of any other discerning features (e.g. associated infiltration, wall thickening, gut dilatation, free fluid, etc) makes 'benign' pneumatosis intestinalis the most likely diagnosis. Multiple etiologies can result in benign pneumatosis such as different types of medication and lung transplantation, both possible causes in this patient.
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