Colon non tumor
Non-neoplastic, non-congenital lesions
Pneumatosis cystoides intestinalis

Author: Raul S. Gonzalez, M.D. (see Authors page)

Revised: 9 January 2017, last major update October 2013

Copyright: (c) 2003-2017,, Inc.

PubMed Search: pneumatosis cystoides intestinalis colon
Cite this page: Pneumatosis cystoides intestinalis. website. Accessed July 21st, 2018.
Definition / general
  • Submucosal gas filled cysts within gastrointestinal tract
  • Entire gastrointestinal tract can be affected
  • In infants, fulminant form is associated with necrotizing enterocolitis and may be fatal
  • Also associated with cystic fibrosis or congenital heart defects
  • In adults, either idiopathic or associated with obstruction, chronic lung disease, scleroderma, chemotherapy, drugs, ischemic colitis, vascular insufficiency or infection with gas producing bacteria, such as Clostridia (Am J Med Sci 2006;332:100)
Clinical features
  • Either benign or fulminant form
  • Often indolent clinical course, although radiographically can resemble carcinoma
  • Patients may have nausea, vomiting, diarrhea
  • Considered a finding, not a diagnosis
Radiology description
  • Multiple, thin walled, air filled submucosal or subserosal cysts
  • Air may be present in peritoneum
Case reports
  • Surgery if bowel necrosis, perforation or peritonitis
Clinical images

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Coronal computed tomography

Gross description
  • Polypoid grape-like masses protruding through mucosa
Gross images

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Multiple subserosal bubbles

Diffuse hemorrhage

Pneumatosis intestinalis

Pneumatosis intestinalis and focal mucosal necrosis

Microscopic (histologic) description
  • Empty submucosal cysts lined by multinucleated giant cells
  • Mucosa may demonstrate cryptitis, crypt abscesses, granulomas
  • Can also resemble lipomatosis
Microscopic (histologic) images

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Submucosal gas filled cysts

Multinucleated giant cells

6 year old girl with ulcerative colitis


Pneumatosis intestinalis
Differential diagnosis