Khairul Najmi Muhammad Nawawi1 , Azlan Helmy Abd Samat2 , Nik Farhan Nik Fuad3 , Lim Li Yi4

1Department of Medicine, Gastroenterology Unit, The National University of Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
2Department of Emergency, Faculty of Medicine, The National University of Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
3Department of Radiology, Faculty of Medicine, The National University of Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia
4Department of Surgery, Faculty of Medicine, The National University of Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia

Keywords: Abdominal X-ray, computed tomography, intramural gas, life-threatening, portal venous gas

Abstract

Pneumatosis intestinalis (PI) is a rare radiological finding, characterized by the presence of gas in the bowel wall. It has a wide spectrum of possible underlying diagnosis ranging from benign to life-threatening conditions. We present a case of a previously healthy male who was initially presented with missed diagnosis of acute appendicitis which had led to perforated appendix. Failure to recognize the significance of PI and its correlation with other clinical information had caused the delay in his surgical intervention. Fortunately, the patient made a steady recovery and was discharged well. It is important to have a high clinical suspicion of life-threatening conditions whenever patients presented with a radiological clue of PI. Failure to incorporate this finding with other clinical clues might lead to devastating consequences and delay the necessary treatment.

How to cite this article: Muhammad Nawawi KN, Abd Samat AH, Nik Fuad NF, Yi LL. Pneumatosis intestinalis: An important radiological clue in a case of missed perforated appendicitis. Turk J Emerg Med 2020;20:86-9

Author Contributions

Actively involved in the care and management of the patient (KNMN, AHAS, NFNF, LLY), Data collection (KNMN), Manuscript writing (KNMN), Critically revised the manuscript (AHAS, NFNF, LLY.

Conflict of Interest

None declared.

Financial Disclosure

None declared.