Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2013

Open Access 01-12-2013 | Case report

Linear asymptomatic pneumatosis as an unexpected finding of computed tomography colonography: a case report

Authors: Nicola Flor, Paola Pricolo, Antonio Rovere, Miriam Mezzanzanica, Mauro Peri, Gianpaolo Cornalba

Published in: Journal of Medical Case Reports | Issue 1/2013

Login to get access

Abstract

Introduction

We discuss asymptomatic colonic pneumatosis, an unexpected finding of computed tomography colonography that we must see as distinct from perforation. Among the papers detailing complications with computed tomography colonography, we found only one report focusing on linear pneumatosis.

Case presentation

We report the case of a 75-year-old Caucasian woman who had a high level of carcinoembryonic antigen, and who underwent computed tomography colonography. Our patient accidentally fell from a chair in the radiology department just before the examination, experiencing a right hip trauma. The examination was negative for colonic lesions but revealed the presence of some air bubbles in her right colon. Our patient remained asymptomatic throughout the procedure and afterwards; no intervention or treatment was necessary.

Conclusion

Radiologists should consider colonic linear pneumatosis among the potential complications of computed tomography colonography, even if it is a rare event, to avoid unnecessary therapy and anxiety for the patient.
Appendix
Available only for authorised users
Literature
1.
go back to reference Pickhardt PJ, Hassan C, Halligan S, Marmo R: Colorectal cancer: CT colonography and colonoscopy for detection–systematic review and meta-analysis. Radiology. 2011, 259: 393-405. 10.1148/radiol.11101887.CrossRefPubMedPubMedCentral Pickhardt PJ, Hassan C, Halligan S, Marmo R: Colorectal cancer: CT colonography and colonoscopy for detection–systematic review and meta-analysis. Radiology. 2011, 259: 393-405. 10.1148/radiol.11101887.CrossRefPubMedPubMedCentral
2.
go back to reference Kim DH, Pickhardt PJ, Taylor AJ, Leung WK, Winter TC, Hinshaw JL, Gopal DV, Reichelderfer M, Hsu RH, Pfau PR: CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007, 357: 1403-1412. 10.1056/NEJMoa070543.CrossRefPubMed Kim DH, Pickhardt PJ, Taylor AJ, Leung WK, Winter TC, Hinshaw JL, Gopal DV, Reichelderfer M, Hsu RH, Pfau PR: CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007, 357: 1403-1412. 10.1056/NEJMoa070543.CrossRefPubMed
3.
go back to reference Johnson CD, Chen MH, Toledano AY, Heiken JP, Dachman A, Kuo MD, Menias CO, Siewert B, Cheema JI, Obregon RG, Fidler JL, Zimmerman P, HortonK M, Coakley K, Iyer RB, Hara AK, Halvorsen RA, Casola G, Yee J, Herman BA, Burgart LJ, Limburg PJ: Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 2008, 359: 1207-1217. 10.1056/NEJMoa0800996.CrossRefPubMedPubMedCentral Johnson CD, Chen MH, Toledano AY, Heiken JP, Dachman A, Kuo MD, Menias CO, Siewert B, Cheema JI, Obregon RG, Fidler JL, Zimmerman P, HortonK M, Coakley K, Iyer RB, Hara AK, Halvorsen RA, Casola G, Yee J, Herman BA, Burgart LJ, Limburg PJ: Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 2008, 359: 1207-1217. 10.1056/NEJMoa0800996.CrossRefPubMedPubMedCentral
4.
go back to reference Regge D, Laudi C, Galatola G, Della Monica P, Bonelli L, Angelelli G, Asnaghi R, Barbaro B, Bartolozzi C, Bielen D, Boni L, Borghi C, Bruzzi P, Cassinis MC, Galia M, Gallo TM, Grasso A, Hassan C, Laghi A, Martina MC, Neri E, Senore C, Simonetti G, Venturini S, Gandini G, Regge D, Laudi C, Galatola G, Della Monica P, Bonelli L: Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer. JAMA. 2009, 301: 2453-2461. 10.1001/jama.2009.832.CrossRefPubMed Regge D, Laudi C, Galatola G, Della Monica P, Bonelli L, Angelelli G, Asnaghi R, Barbaro B, Bartolozzi C, Bielen D, Boni L, Borghi C, Bruzzi P, Cassinis MC, Galia M, Gallo TM, Grasso A, Hassan C, Laghi A, Martina MC, Neri E, Senore C, Simonetti G, Venturini S, Gandini G, Regge D, Laudi C, Galatola G, Della Monica P, Bonelli L: Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer. JAMA. 2009, 301: 2453-2461. 10.1001/jama.2009.832.CrossRefPubMed
5.
go back to reference Graser A, Stieber P, Nagel D, Schäfer C, Horst D, Becker CR, Nikolaou K, Lottes A, Geisbüsch S, Kramer H, Wagner AC, Diepolder H, Schirra J, Roth HJ, Seidel D, Göke B, Reiser MF, Kolligs FT: Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut. 2009, 58: 241-248. 10.1136/gut.2008.156448.CrossRefPubMed Graser A, Stieber P, Nagel D, Schäfer C, Horst D, Becker CR, Nikolaou K, Lottes A, Geisbüsch S, Kramer H, Wagner AC, Diepolder H, Schirra J, Roth HJ, Seidel D, Göke B, Reiser MF, Kolligs FT: Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut. 2009, 58: 241-248. 10.1136/gut.2008.156448.CrossRefPubMed
6.
go back to reference Pickhardt PJ: The incidence of colonic perforation at CT colonography: review of the existing data and the implications for screening of asymptomatic adults. Radiology. 2006, 239: 313-316. 10.1148/radiol.2392052002.CrossRefPubMed Pickhardt PJ: The incidence of colonic perforation at CT colonography: review of the existing data and the implications for screening of asymptomatic adults. Radiology. 2006, 239: 313-316. 10.1148/radiol.2392052002.CrossRefPubMed
7.
go back to reference Burling D, Halligan S, Slater A, Noakes MJ, Taylor SA: Potentially serious adverse events associated with CT colonography performed in symptomatic patients: a national survey of the UK. Radiology. 2006, 239: 464-471. 10.1148/radiol.2392051101.CrossRefPubMed Burling D, Halligan S, Slater A, Noakes MJ, Taylor SA: Potentially serious adverse events associated with CT colonography performed in symptomatic patients: a national survey of the UK. Radiology. 2006, 239: 464-471. 10.1148/radiol.2392051101.CrossRefPubMed
8.
go back to reference Sosna J, Blachar A, Amitai M, Barmeir E, Peled N, Goldberg SN, Bar-Ziv J: Assessment of the risk of colonic perforation at CT colonography in a multi-center large cohort. Radiology. 2006, 239: 457-463. 10.1148/radiol.2392050287.CrossRefPubMed Sosna J, Blachar A, Amitai M, Barmeir E, Peled N, Goldberg SN, Bar-Ziv J: Assessment of the risk of colonic perforation at CT colonography in a multi-center large cohort. Radiology. 2006, 239: 457-463. 10.1148/radiol.2392050287.CrossRefPubMed
9.
go back to reference Hachlander T, Wenger H: Pneumatosis intestinalis coli – a rare find in CT-colonoscopy. Rofo. 2005, 177: 759-761. 10.1055/s-2004-813895.CrossRef Hachlander T, Wenger H: Pneumatosis intestinalis coli – a rare find in CT-colonoscopy. Rofo. 2005, 177: 759-761. 10.1055/s-2004-813895.CrossRef
10.
go back to reference Pickhardt PJ, Kim DH, Taylor AJ: Asymptomatic pneumatosis at CT colonography: a benign self-limited imaging finding distinct from perforation. AJR. 2008, 190: W112-W117. 10.2214/AJR.07.2843.CrossRefPubMed Pickhardt PJ, Kim DH, Taylor AJ: Asymptomatic pneumatosis at CT colonography: a benign self-limited imaging finding distinct from perforation. AJR. 2008, 190: W112-W117. 10.2214/AJR.07.2843.CrossRefPubMed
12.
go back to reference St Peter SD, Abbas MA, Kelly KA: The spectrum of pneumatosis intestinalis. Arch Surg. 2003, 138: 68-75. 10.1001/archsurg.138.1.68.CrossRefPubMed St Peter SD, Abbas MA, Kelly KA: The spectrum of pneumatosis intestinalis. Arch Surg. 2003, 138: 68-75. 10.1001/archsurg.138.1.68.CrossRefPubMed
13.
go back to reference Soyer P, Martin-Grivaud S, Boudiaf M, Malzy P, Duchat F, Hamzi L, Pocard M, Vahedi K, Rymer R: Linear or bubbly: a pictorial review of CT features of intestinalis pneumatosis adults. J Radiol. 2008, 89: 1907-1920. 10.1016/S0221-0363(08)74786-3.CrossRefPubMed Soyer P, Martin-Grivaud S, Boudiaf M, Malzy P, Duchat F, Hamzi L, Pocard M, Vahedi K, Rymer R: Linear or bubbly: a pictorial review of CT features of intestinalis pneumatosis adults. J Radiol. 2008, 89: 1907-1920. 10.1016/S0221-0363(08)74786-3.CrossRefPubMed
14.
go back to reference Ho LM, Paulson EK, Thompson WM: Pneumatosis intestinalis in the adult: benign to life-threatening causes. AJR. 2007, 188: 1604-1613. 10.2214/AJR.06.1309.CrossRefPubMed Ho LM, Paulson EK, Thompson WM: Pneumatosis intestinalis in the adult: benign to life-threatening causes. AJR. 2007, 188: 1604-1613. 10.2214/AJR.06.1309.CrossRefPubMed
15.
go back to reference Kelly BS, Meyers P, Choe KA, Hurst J, Luchette FA: Traumatic pneumatosis cystoides intestinalis with portal venous air embolism. J Trauma. 1997, 42: 112-113. 10.1097/00005373-199701000-00020.CrossRefPubMed Kelly BS, Meyers P, Choe KA, Hurst J, Luchette FA: Traumatic pneumatosis cystoides intestinalis with portal venous air embolism. J Trauma. 1997, 42: 112-113. 10.1097/00005373-199701000-00020.CrossRefPubMed
Metadata
Title
Linear asymptomatic pneumatosis as an unexpected finding of computed tomography colonography: a case report
Authors
Nicola Flor
Paola Pricolo
Antonio Rovere
Miriam Mezzanzanica
Mauro Peri
Gianpaolo Cornalba
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2013
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-7-205

Other articles of this Issue 1/2013

Journal of Medical Case Reports 1/2013 Go to the issue