The patient is a 74-year-old woman with mild abdominal discomfort during the previous 2–3 weeks and chronic constipation, who presented abdominal pain that had been increasing over the previous 5h, with no defined focus. Lab work showed leukocytosis with neutrophilia, increased C-reactive protein and procalcitonin and respiratory alkalosis. Pneumatosis coli was evident in the sigmoid colon on abdominal X-ray. Computed tomography confirmed segmental pneumatosis in the sigmoid colon, with no signs of acute diverticulitis (Fig. 1). Considering the patient's symptoms, we decided to perform urgent exploratory laparotomy.
During surgical exploration, we observed the sigmoid colon had a normal consistency with no signs of ischemia, but there was segmental pneumatosis (Fig. 2). We found a limited amount of serous fluid in the pelvis, with negative microbiological cultures. Given the absence of other findings, we decided to perform a lavage of the abdominal cavity and leave a drain tube in the left paracolic gutter. The patient progressed favorably and was discharged on the 4th day post-op, without further treatment.
Please cite this article as: Sobrino Grande Á, Sanz Muñoz P, Bertomeu García A, Jover Navalón JM. Neumatosis coli segmentaria en paciente con abdomen agudo. Cir Esp. 2017;95:544.
