CTICasesBenign Colonic Pneumatosis after Lung Transplant
Imaging findings
A patient about two weeks after double lung transplant for scleroderma showed curvilinear lucency in the upper abdomen on the post-operative chest radiograph. Abdominal radiographs and CT demonstrate extensive predominantly colonic pneumatosis that progressed over time. Exploratory surgery for developing pain found only pneumatosis with no ischemic bowel, so nothing was resected.
Key takeaways
Extensive large-bowel pneumatosis after lung transplantation can be a benign, non-ischemic phenomenon, though it must be distinguished from bowel ischemia, to which transplant patients are also predisposed. Scleroderma patients may have bowel wall abnormalities that contribute. On post-operative chest radiographs, the most important findings are often outside the lungs, and careful inspection of the upper abdomen and corners of the image is essential.
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