CTICasesPneumatosis Coli and Pneumomediastinum post-Lung Transplant
Imaging findings
CT chest and abdomen in an asymptomatic patient post-lung transplantation show extensive air in the mediastinum (pneumomediastinum), retroperitoneum, and within the bowel wall of the colon (pneumatosis intestinalis/coli), without free intraperitoneal air or signs of bowel ischemia.
Key takeaways
Pneumatosis coli can present as a benign, asymptomatic, and chronic finding in post-transplant patients. The gas can dissect along the mesenteric vessels into the retroperitoneum and mediastinum, causing asymptomatic pneumomediastinum. Recognizing this benign pathway is important to avoid unnecessary laparotomy.
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