Pneumatosis intestinalis associated with pulmonary disorders

Purpose To determine the clinical features, imaging findings and possible causes of pneumatosisintestinalis (PI) in thoracic disorder patients.Materials and Methods From 2005 to 2017, Among 62 PI patients, four of PI related with thoracicdisease (6%) were identified. Medical records were reviewed to determine the clinical presentation,laboratory findings and treatment at the time of presentation of PI. Two experiencedchest radiologists reviewed all imaging studies and recorded specific findings for each patient.Results The causative thoracic diseases for each four patient were severe asthma, emphysemaand airway obstruction. The imaging appearance of PI, including the involved bowel segmentand pattern of the air, were divided into two mesenteric vascular territories; three of our casesshowed linear pattern of PI located in the ascending & proximal transverse colon and the fourthcase (lung cancer) had bubbly and cystic PI in the distal transverse and descending colon. All ofthe remaining 3 patients, except one patient who had not been followed up, improved within 1month by conservative treatment.Conclusion Thoracic disorder with obstructive lung disease may result in the development ofbenign PI. Such PI in thoracic disease patients has a similar linear and cystic appearance withischemic bowel disease, but can nevertheless be managed by conservative treatment.