Presentation
Asymptomatic. Incidental pneumoperitoneum discovered on spine CT for follow up of lung cancer metastasis. Patient then had abdominal CT scan to find the cause of free air.
Patient Data
Presence of intraperitoneal and retroperitoneal free gas with atypical distribution. There is a periumbilical dilated segment of small bowel surrounded by multiple gas filled cysts within the mesentery.
Case Discussion
Patient was followed clinically and subsequentially discharged without complication.
Pneumatosis cystoides intestinalis can cause pneumoperitoneum when cysts rupture. In the absence of severe symptoms, emergent exploratory laparotomy should not be performed.