Pneumatosis cystoides intestinalis: A complicated case presentation

INTRODUCTION: Pneumatosis Cystoides Intestinalis (PCI) is a fairly rare condition that is, however, becoming of increasing incidence. It is difficult to ascertain as many patients are asymptomatic, but, in adults, if it does present it usually presents in the fifty-to-eighty years age groups. IMPORTANCE: It may be primary (15% - idiopathic and benign condition) or secondary (85% - usually in neonates and due to necrotising enterocolitis) but the aetiology is unclear, with some theories that have been put forward. Many consider its pathogenesis to be due to increased intra-luminal intestinal pressure and, therefore, build-up of gas from commensal gut bacteria. Imaging and histology are important in diagnosis. CASE PRESENTATION: This case presentation explores the complicated presentation of a patient with PCI and his management, thereof, in order to review the appropriate investigations and the subsequent options of management. CONCLUSION: Because it is a poorly understood condition with varying presentations, it is often misdiagnosed. The diagnosis is critical to allow the correct and most appropriate management to be carried out: non-surgical supportive care versus surgical intervention with resection and stoma or anastomosis.