MRI suspicion of pneumoperitoneum revealing pneumatosis cystoides intestinalis on CT

Mahmoud Hsairi; Yahya El Harras; Achraf Saidi; Kaoutar Imrani; Nassar Ittimade

doi:10.36948/ijfmr.2026.v08i03.80227

MRI suspicion of pneumoperitoneum revealing pneumatosis cystoides intestinalis on CT

Author(s)	Dr. Mahmoud Hsairi, Prof. Yahya El Harras, Dr. Achraf Saidi, Prof. Kaoutar Imrani, Prof. Nassar Ittimade
Country	Morocco
Abstract	Background: Pneumatosis cystoides intestinalis (PCI) is an uncommon entity defined by gas-filled cysts within the bowel wall. Although often benign, it may simulate perforation or pneumoperitoneum on imaging, particularly in patients with underlying bowel disease. Its association with Crohn’s disease remains rare and diagnostically challenging. Case presentation: A 30-year-old man with longstanding Crohn’s disease, initially followed in Libya and lost to follow-up since 2021, was referred for reassessment after irregular corticosteroid use and recurrent abdominal pain. MR enterography demonstrated multifocal active small-bowel disease, dominated by a 20-cm distal jejunal segment with mural thickening up to 10 mm, heterogeneous transmural enhancement, adjacent mesenteric inflammatory change, and locoregional lymphadenopathy; additional inflammatory thickening involved the distal ileum over 12 cm. During image review, focal signal voids abutting diseased bowel loops raised the unresolved possibility of gas. As this finding could not be confidently characterized on MR images, a targeted abdominopelvic CT was obtained. CT demonstrated moderate pneumoperitoneum associated with predominantly colonic cystic intramural gas collections, establishing the diagnosis of pneumatosis cystoides intestinalis rather than frank bowel perforation. In the absence of peritoneal irritation, bowel ischemia, or hemodynamic instability, the patient was managed conservatively with surveillance alone. Conclusion: This case highlights the diagnostic value of CT in confirming pneumatosis cystoides intestinalis when MRI findings are equivocal. In patients with Crohn’s disease,PCI may mimic pneumoperitoneum or bowel perforation , making recognition of its characteristic imaging appearance essential to avoid unnecessary surgical intervention.
Keywords	Pneumatosis cystoides intestinalis; Crohn’s disease; Pneumoperitoneum; Magnetic resonance enterography; Computed tomography; Intestinal wall gas; Conservative management
Field	Medical / Pharmacy
Published In	Volume 8, Issue 3, May-June 2026
Published On	2026-06-02
DOI	https://doi.org/10.36948/ijfmr.2026.v08i03.80227

View / Download PDF File

E-ISSN 2582-2160

doi

CrossRef DOI is assigned to each research paper published in our journal.

IJFMR DOI prefix is
10.36948/ijfmr

Downloads

Research Paper Format Copyright Permission Form and Undertaking Form Cover Page Vol 8 Isu 3 Cover Page Vol 8 Isu 2 Cover Page Vol 8 Isu 2

All research papers published on this website are licensed under Creative Commons Attribution-ShareAlike 4.0 International License, and all rights belong to their respective authors/researchers.

CC-BY-SA

About IJFMR Fees & Payment Current Issue Publication Archive	Submit Research Paper Track Submission Status Publication Guidelines Publication Ethics Peer Review & Plagiarism	Join as a Reviewer Editors & Reviewers Reviewer Referral Program Get Reviewer Membership Certi.	Website/Journal Policies Usage Policy Content Policies Privacy Policy

Contact Us		+91-9687-828-838	editor@ijfmr.com

International Journal For Multidisciplinary Research

A Widely Indexed Open Access Peer Reviewed Multidisciplinary Bi-monthly Scholarly International Journal

MRI suspicion of pneumoperitoneum revealing pneumatosis cystoides intestinalis on CT

Share this