Pseudopneumoperitoneum in chronic intestinal pseudoobstruction: A case report

Luigi Camera, Milena Calabrese, Giovanni Sarnelli, Margaret Longobardi, Alba Rocco, Rosario Cuomo, Marco Salvatore

Research output: Contribution to journalArticlepeer-review

Abstract

Chronic intestinal pseudo-obstruction (CIPO) is a rare disease due to a severe gastrointestinal motility disorder which may mimic, on both clinical and radiological grounds, mechanical obstruction. We report a case of a 26-year-old woman who presented to our institution for plain abdominal radiography for referred long-lasting constipation with recurrent episodes of abdominal pain and distension. At X-ray, performed both in the upright and supine position, an isolated air-fluid level was depicted in the left flank, together with a number of radiological signs suggestive of pneumoperitoneum. First, subphrenic radiolucency could be observed in the upright film. Second, the intestinal wall of some jejunal loops appeared to be outlined in the right flank. Third, the inferior cardiac border was clearly depicted in the upright film. The patient however had no evidence of peritoneal signs but only hypoactive bowel movements. Unenhanced multi-detector computed tomography (MDCT) of the abdomen and pelvis was therefore performed. MDCT revealed abnormal air-driven distension of the small and large bowel, without evidence of extraluminal air. All radiological signs of pneumoperitoneum turned out to be false-positive results. The patient was submitted to pan-colonoscopy and to anorectal manometry to rule out Hirshprung's disease, and was finally discharged with a diagnosis of CIPO.

Original languageEnglish
Pages (from-to)2972-2975
Number of pages4
JournalWorld Journal of Gastroenterology
Volume17
Issue number24
DOIs
Publication statusPublished - Jun 28 2011

Keywords

  • Abdominal radiography
  • Chronic intestinal pseudo-obstruction
  • Motility disorders
  • Multi-detector computed tomography
  • Pseudopneumoperitoneum

ASJC Scopus subject areas

  • Gastroenterology

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