Project Title

Asymptomatic Free Air: An Abnormal Presentation of Pneumatosis

Authors' Affiliations

Andrew Carey, ETSU Quillen College of Medicine, Johnson City, TN Joseph Garner, ETSU Quillen College of Medicine, Johnson City, TN Mateo Guarderas MD, ETSU Quillen College of Medicine General Surgery Residency, Johnson City, TN John Vance DO, General Surgery, Bristol, TN Carlos Floresguerra MD, General Surgery, Johnson City, TN

Location

Mt Mitchell

Start Date

4-12-2019 9:00 AM

End Date

4-12-2019 2:30 PM

Poster Number

132

Faculty Sponsor’s Department

Surgery

Name of Project's Faculty Sponsor

Dr. John Vance

Type

Poster: Competitive

Classification of First Author

Graduate Student-Doctoral

Project's Category

Anatomical Systems or Sites, Digestive System, Excretory System, Sensory System, Digestive Diseases and Disorders, Disease Symptoms

Abstract Text

Pneumatosis intestinalis, air within the bowel wall, continues to have an elusive etiology due to its varied clinical presentation and associated disease processes. Pneumatosis may be an incidental finding on a routine CT Scan or it could present as peritonitis with intra-abdominal free air. The pathogenesis, therefore, is likely to be multifactorial rather than directly related to one particular, inciting pathology. Here we present a case of a 73-year-old male scheduled for a non-emergent incisional hernia repair who was found to have peritoneal free air without physical exam findings of peritonitis. This unusual case illustrates a rare presentation of small bowel, omental, and abdominal wall pneumatosis. The objective of this presentation is to broaden the clinician’s understanding of pneumatosis intestinalis, including a recommendation to discern the underlying illness as emergent or benign. Finally, we make the case for clinical intuition and the physical exam.

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Apr 12th, 9:00 AM Apr 12th, 2:30 PM

Asymptomatic Free Air: An Abnormal Presentation of Pneumatosis

Mt Mitchell

Pneumatosis intestinalis, air within the bowel wall, continues to have an elusive etiology due to its varied clinical presentation and associated disease processes. Pneumatosis may be an incidental finding on a routine CT Scan or it could present as peritonitis with intra-abdominal free air. The pathogenesis, therefore, is likely to be multifactorial rather than directly related to one particular, inciting pathology. Here we present a case of a 73-year-old male scheduled for a non-emergent incisional hernia repair who was found to have peritoneal free air without physical exam findings of peritonitis. This unusual case illustrates a rare presentation of small bowel, omental, and abdominal wall pneumatosis. The objective of this presentation is to broaden the clinician’s understanding of pneumatosis intestinalis, including a recommendation to discern the underlying illness as emergent or benign. Finally, we make the case for clinical intuition and the physical exam.