Pneumatosis Intestinalis (PI) is uncommon and can may be a benign condition or an indication of a life-threatening emergency. Computed Tomography (CT) of the abdomen may show findings that can help to identify clinically significant PI.
Patient selection: beyond the neonatal period (when the risk of necrotizing enterocolitis is high)
Findings on CT scan associated with significant pneumatosis:
(1) thickening of soft-tissue bowel wall (bowel wall thickening)
• Extensive disease is seen more often in benign PI.
• Peritoneal free air by itself was not diagnostic of clinically worrisome PI.
Each of the CT findings can be seen in worrisome and benign PI, so the number of findings and the clinical situation need to be taken into account when deciding on how to manage the patient.
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