Unveiling gas in the bowel wall: the role of point-of-care ultrasound in diagnosing pneumatosis intestinalis
Dublin Core
Title
Unveiling gas in the bowel wall: the role of point-of-care ultrasound in diagnosing pneumatosis intestinalis
Subject
Pneumatosis intestinalis, Point of Care Ultrasound, Pediatric emergency medicine, Enterocolitis
Description
Abstract
Background Pneumatosis intestinalis (PI) is an infrequent but clinically significant finding that can be a surrogate
indicator of underlying severe gastrointestinal conditions, particularly in pediatrics. Despite its typical association with
necrotizing enterocolitis (NEC), PI can occasionally present without overt clinical signs, which presents a diagnostic
dilemma.
Case presentation A 35-day-old preterm infant who presented to the emergency department with loose stools and
vomiting. Although the clinical examination was unremarkable, point-of-care ultrasound (POCUS) revealed multiple
intramural echogenic foci consistent with PI. Subsequent abdominal X-rays confirmed the diagnosis. The patient was
managed conservatively with bowel rest, intravenous fluids, and antibiotics, leading to resolution of symptoms and
discharge in stable condition.
Conclusion The case uniquely demonstrates the feasibility and potential diagnostic advantage of POCUS as a
diagnostic tool for rapidly identifying PI, especially in the absence of classical clinical signs—highlighting its novel
utility in emergency pediatric care.
Keywords Pneumatosis intestinalis, Point of Care Ultrasound, Pediatric emergency medicine, Enterocolitis
Background Pneumatosis intestinalis (PI) is an infrequent but clinically significant finding that can be a surrogate
indicator of underlying severe gastrointestinal conditions, particularly in pediatrics. Despite its typical association with
necrotizing enterocolitis (NEC), PI can occasionally present without overt clinical signs, which presents a diagnostic
dilemma.
Case presentation A 35-day-old preterm infant who presented to the emergency department with loose stools and
vomiting. Although the clinical examination was unremarkable, point-of-care ultrasound (POCUS) revealed multiple
intramural echogenic foci consistent with PI. Subsequent abdominal X-rays confirmed the diagnosis. The patient was
managed conservatively with bowel rest, intravenous fluids, and antibiotics, leading to resolution of symptoms and
discharge in stable condition.
Conclusion The case uniquely demonstrates the feasibility and potential diagnostic advantage of POCUS as a
diagnostic tool for rapidly identifying PI, especially in the absence of classical clinical signs—highlighting its novel
utility in emergency pediatric care.
Keywords Pneumatosis intestinalis, Point of Care Ultrasound, Pediatric emergency medicine, Enterocolitis
Creator
Rida Jawed1
and Noman Ali1*
and Noman Ali1*
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Rida Jawed1
and Noman Ali1*, “Unveiling gas in the bowel wall: the role of point-of-care ultrasound in diagnosing pneumatosis intestinalis,” Repository Horizon University Indonesia, accessed April 18, 2026, https://repository.horizon.ac.id/items/show/13253.