Pneumatosis intestinalis
For patient information on this topic, click here.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pneumatosis intestinalis is a sign on x-ray which is highly suggestive for necrotizing enterocolitis. The literal meaning is gas in the bowel wall, as opposed to in the lumen which is normal. Pneumatosis intestinalis (PI) is defined as the presence of gas in the bowel wall. PI is associated with numerous conditions, ranging from benign to life threatening.
Pathophysiology
There are two theories on pathogenesis of pneumatois intestinalis. Mechanical theory suggests that gas dissects into the bowel wall from either the intestinal lumen or the lungs via the mediastinum due to some mechanism causing increased pressure. Bacterial theory proposes that gas-forming bacilli enter the submucosa through mucosal rents or increased mucosal permeability and produce gas within the bowel wall.
References
Pathophysiology
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please help WikiDoc by adding more content here. It’s easy! Click here to learn about editing.
Overview
There are two theories on pathogenesis of pneumatois intestinalis. Mechanical theory suggests that gas dissects into the bowel wall from either the intestinal lumen or the lungs via the mediastinum due to some mechanism causing increased pressure. Bacterial theory proposes that gas-forming bacilli enter the submucosa through mucosal rents or increased mucosal permeability and produce gas within the bowel wall.
References
Causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
Pneumatosis intestinalis is primarily caused by trauma to the intestines from ischemic disease and surgical procedures. Life threatening causes should be identified immediately, including intestinal obstruction, perforation, ingestion of toxic chemicals, ischemia, or other sources of trauma. Bacterial infections are also common sources of pneumatosis intenstinalis.
Causes[1]
Life threatening causes
- Intestinal ischemia
- Mesenteric vascular disease
- Intestinal obstruction
- Colitis
- Ingestion of corrosive agents
- Toxic megacolon
- Trauma
- Chronic obstructive pulmonary disease
- Intestinal perforation
- Ruptured diverticulum
Common Causes
- Adynamic ileus
- Asthma
- Bowel obstruction
- Bronchitis
- Chemotherapy
- Corticosteroids
- Cystic fibrosis
- Emphysema
- Endoscopy
- Enteritis
- Idiopathic
- Lactulose
- Organ transplantation
- Peptic ulcers
- Pneumatosis cystoides intestinalis
- Postsurgical anastomosis
- Scleroderma
- Systemic lupus erythematosus
- Intestinal ischemia
- Mesenteric vascular disease
- Intestinal obstruction
Causes by Organ System
Causes in Alphabetical Order
- Adynamic ileus
- Aids
- Amyloidosis
- Asthma
- Bone marrow transplantation
- Bowel ischemia
- Bowel necrosis
- Bowel obstruction
- Bronchitis
- Caustic ingestions
- Cecal ileus
- Chemotherapy
- Chronic obstructive pulmonary disease
- Clostridium difficile
- Colitis
- Collagen vascular disease
- Colonoscopy
- Corrosive agents
- Corticosteroids
- Crohn’s disease
- Cryptosporidium
- Cystic fibrosis
- Cytomegalovirus
- Diabetes
- Emphysema
- Emphysematous gastritis
- Endoscopic retrograde cholangiopancreatography
- Endoscopic trauma
- Endoscopy
- Enteritis
- Esophagogastroduodenoscopy
- Feeding jejunostomy tube
- Graft versus host disease
- Hirschprung’s disease
- Idiopathic
- Intestinal infarction
- Intestinal ischemia
- Intestinal obstruction
- Intestinal perforation
- Intestinal pseudoobstruction
- Intracellulare
- Ischaemic colitis
- Jejunoileal bypass
- Lactulose
- Lymphoproliferative disorders
- Mechanical ventilation
- Mesenteric ischemia
- Mesenteric vascular disease
- Mycobacterium avium
- Necrotizing enterocolitis
- Neutropenic colitis
- Organ transplantation
- Peptic ulcer disease
- Postsurgical anastomosis
- Pyloric stenosis
- Ruptured diverticulum
- Scleroderma
- Sclerotherapy
- Sepsis
- Solid organ transplantation
- Sorbitol
- Stent perforation
- Steroids
- Surgical trauma
- Systemic lupus erythematosus
- Systemic sclerosis
- Toxic megacolon
- Trauma
- Tuberculosis
- Typhlitis
- Ulcerative colitis
- Voglibose
- Volvulus
- Whipples disease
References
Differentiating Pneumatosis Intestinalis from other Conditions
Please help WikiDoc by adding content here. It’s easy! Click here to learn about editing.
References
Epidemiology and Demographics
Please help WikiDoc by adding content here. It’s easy! Click here to learn about editing.
References
Risk Factors
Please help WikiDoc by adding content here. It’s easy! Click here to learn about editing.
References
Natural History, Complications and Prognosis
Please help WikiDoc by adding content here. It’s easy! Click here to learn about editing.
References
Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Looking for the patient version?
© 2026 MyEClinic – IFTM Institut für Telematik in der Medizin GmbH