Pneumatosis Intestinalis with Associated Retroperitoneal Air

Abstract

IN THE LAST FEW YEARS it has been noted by several authors that pneumatosis intestinalis occurs in lung disease, particularly in asthma, more often than can be accounted for by chance. Doub and Shea,¹in 1960, reported 16 cases of pneumatosis intestinalis, 15 in patients with asthma and one in conjunction with pulmonary fibrosis. They suggested the existence of a cause-and-effect relationship between allergy or asthma and air in the intestinal wall. In 1961, Keyting et al²reported seven cases of pneumatosis intestinalis, six of which were associated with pulmonary disease. The concept was advanced that alveolar rupture, pneumomediastinum, and retroperitoneal air advancing along vascular routes to the bowel wall probably accounted for most cases of so-called "primary pneumatosis." They referred to Macklin's³work which clearly showed that alveolar rupture could result in pneumomediastinum, which gas could then dissect in several directions, one of which was to