Pneumatosis Intestinalis: Do Not Excise These “Polyps”!

A 52-year-old male with a history of recurrent deep venous thrombosis underwent a CT scan of the chest investigating a suspected pulmonary embolism. The scan revealed thickening of the splenic flexure with foci of air adjacent to the colon (Figure 1). The patient reported mild nausea and chronic intermittent hemorrhoidal bleeding without abdominal pain. Physical exam and labwork were unremarkable. Colonoscopy to evaluate this radiographic finding demonstrated a corresponding cluster of cystic submucosal lesions of varying sizes with normal overlying mucosa consistent with pneumatosis intestinalis (Figure 2). The patient was discharged home and is being followed up in the gastroenterology clinic.