CTICasesBenign Pneumatosis Intestinalis after Lung Transplant
Imaging findings
A patient after double lung transplant for scleroderma-related fibrosis has funny lucency around the bowel in the upper abdomen on the post-operative chest radiographs. Abdominal radiograph and CT show extensive bowel-wall pneumatosis, and the patient had essentially no symptoms; surgery monitored her and did nothing.
Key takeaways
Extensive bowel pneumatosis can be benign, particularly in scleroderma (which also causes benign pneumoperitoneum and dysmotility with a hidebound small bowel) and after lung transplant, and does not necessarily indicate ischemia. Immunosuppression still warrants excluding occult infection, but an asymptomatic patient with otherwise benign features can be managed conservatively; careful attention to the upper abdomen on chest imaging catches these findings.
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