Pneumatosis Coli

Figure 1 A 47-year-old man presented with a 2-week history of mid-abdominal pain. He denied having any fever, chills, nausea, vomiting, or diarrhea. Computed tomography of the abdomen revealed numerous air-filled cysts involving the splenic flexure of the colon (arrow), a finding consistent with pneumatosis coli. A colonoscopy examination was then performed, which revealed sigmoid diverticulosis.

Figure 2 Multiple large, intramural, cyst-like structures were seen at the level of the splenic flexure at colonoscopy.

Figure 3 Histopathologic examination of biopsy specimens revealed cystic air-filled spaces within the submucosa which were partially lined by clusters of foreign-body macrophages (hematoxylin & eosin stain, magnification × 10). A few weeks later the patient developed a perforated diverticulitis, which was managed medically; sigmoidectomy is planned.