Pneumatosis Cystoides Intestinalis, Is theEmergency Surgery Inevitable: Case Report

Pneumatosis cystoides intestinalis is a rare clinical phenomenon in which there is presence of gas filled cysts in the gut wall. Its exact cause is not known but this condition is commonly associated with smoking and other factors leading to raised intra-abdominal pressure. Sometimes these gasses filled cysts may rupture on their own or secondary to some surgical intervention leading to presence of free gas in the abdomen or retroperitoneum. We present here a case report of the patient who presented to the emergency room with pain abdomen and a large amount of free gas in the abdomen seen on erect X-ray of the abdomen. Here comes the challenge to the surgeon, whether to operate or not. Contrast Enhanced Computerised Tomography (CECT) scan of the abdomen is a better modality for diagnosing Pneumatosis cystoides intestinalis (PCI) and it can prevent unnecessary surgeries. However, the management of this condition is mainly nonsurgical, and oxygen forms the mainstay of therapy.