{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T10:18:32Z","timestamp":1785838712816,"version":"3.56.0"},"reference-count":71,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:00:00Z","timestamp":1777680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Emerg Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pneumatosis intestinalis (PI) is the imaging finding of air within the bowel wall. It constitutes a diagnostic challenge due to its broad differential and overlap in imaging appearances between benign and serious causes. A multidisciplinary approach is essential for accurate diagnosis and timely intervention, to optimize outcomes and minimize unnecessary procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This article aims to synthesize the literature to lay out the current state of the art in diagnosing and managing PI and discuss future perspectives. We review a series of associated imaging features including portomesenteric venous gas, vascular thrombosis, abnormal bowel wall enhancement, and bowel wall thickening or thinning. We also discuss less specific but commonly seen findings like pneumoperitoneum, ascites and fat stranding, emphasizing their context-dependent significance. We review nuances in clinical interpretation of the severity of PI, discuss the discordance in interpretation of certain clinical markers, and important considerations in specific populations. To finish, we describe ongoing efforts related to risk stratification and its importance in PI management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10140-026-02472-4","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:33:59Z","timestamp":1777685639000},"page":"873-887","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pneumatosis intestinalis revisited: associated imaging findings, clinical correlation, management, risk stratification and future perspectives"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5404-132X","authenticated-orcid":false,"given":"Kathy","family":"Truong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waseem","family":"Wahood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cibele","family":"Luna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Dosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4331-7326","authenticated-orcid":false,"given":"Yamil\u00e9","family":"Blain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"issue":"1","key":"2472_CR1","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1007\/s11547-014-0461-5","volume":"120","author":"F Lassandro","year":"2015","unstructured":"Lassandro F, Valente T, Rea G et al (2015) Imaging assessment and clinical significance of pneumatosis in adult patients. Radiol Med 120(1):96\u2013104. https:\/\/doi.org\/10.1007\/s11547-014-0461-5","journal-title":"Radiol Med"},{"issue":"5","key":"2472_CR2","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1007\/s00261-020-02639-8","volume":"47","author":"G Lassandro","year":"2022","unstructured":"Lassandro G, Picchi SG, Romano F et al (2022) Intestinal pneumatosis: differential diagnosis. Abdom Radiol 47(5):1529\u20131540. https:\/\/doi.org\/10.1007\/s00261-020-02639-8","journal-title":"Abdom Radiol"},{"issue":"6","key":"2472_CR3","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.2214\/AJR.06.1309","volume":"188","author":"LM Ho","year":"2007","unstructured":"Ho LM, Paulson EK, Thompson WM (2007) Pneumatosis intestinalis in the adult: benign to life-threatening causes. AJR Am J Roentgenol 188(6):1604\u20131613. https:\/\/doi.org\/10.2214\/AJR.06.1309","journal-title":"AJR Am J Roentgenol"},{"key":"2472_CR4","unstructured":"Im J, Anjum F (2025) Pneumatosis Intestinalis. StatPearls Publishing, Treasure Island (FL). https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK564381\/"},{"issue":"1","key":"2472_CR5","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s13244-010-0055-2","volume":"2","author":"JH Wang","year":"2011","unstructured":"Wang JH, Furlan A, Kaya D, Goshima S, Tublin M, Bae KT (2011) Pneumatosis intestinalis versus pseudo-pneumatosis: review of CT findings and differentiation. Insights Imaging 2(1):85\u201392. https:\/\/doi.org\/10.1007\/s13244-010-0055-2","journal-title":"Insights Imaging"},{"issue":"3","key":"2472_CR6","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.diii.2018.01.004","volume":"99","author":"P Copin","year":"2018","unstructured":"Copin P, Zins M, Nuzzo A et al (2018) Acute mesenteric ischemia: A critical role for the radiologist. Diagn Interv Imaging 99(3):123\u2013134. https:\/\/doi.org\/10.1016\/j.diii.2018.01.004","journal-title":"Diagn Interv Imaging"},{"issue":"2","key":"2472_CR7","doi-asserted-by":"publisher","first-page":"173","DOI":"10.2214\/AJR.22.28140","volume":"220","author":"MC Olson","year":"2023","unstructured":"Olson MC, Bach CR, Wells ML et al (2023) Imaging of bowel ischemia: an update, from the AJR special series on emergency radiology. AJR Am J Roentgenol 220(2):173\u2013185. https:\/\/doi.org\/10.2214\/AJR.22.28140","journal-title":"AJR Am J Roentgenol"},{"issue":"6","key":"2472_CR8","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.2214\/ajr.177.6.1771319","volume":"177","author":"W Wiesner","year":"2001","unstructured":"Wiesner W, Mortel\u00e9 KJ, Glickman JN, Ji H, Ros PR (2001) Pneumatosis intestinalis and portomesenteric venous gas in intestinal ischemia. AJR Am J Roentgenol 177(6):1319\u20131323. https:\/\/doi.org\/10.2214\/ajr.177.6.1771319","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"2472_CR9","first-page":"369","volume":"52","author":"Z Rajkovi\u0107","year":"2013","unstructured":"Rajkovi\u0107 Z, Papes D, Altarac S, Arslani N (2013) Differential diagnosis and clinical relevance of pneumobilia or portal vein gas on abdominal x-ray. Acta Clin Croat 52(3):369\u2013373","journal-title":"Acta Clin Croat"},{"key":"2472_CR10","first-page":"386","volume-title":"ERCP","author":"SE Coughlin","year":"2024","unstructured":"Coughlin SE, Das KK, Kochman ML (2024) Dilated Bile Duct and Pneumobilia. In: Baron TH, Carr-Locke DL, Kozareck RA, Nageshwar R (eds) ERCP, 4th edn. Elsevier, pp 386\u2013387","edition":"4"},{"issue":"29","key":"2472_CR11","doi-asserted-by":"publisher","first-page":"3585","DOI":"10.3748\/wjg.15.3585","volume":"15","author":"B Abboud","year":"2009","unstructured":"Abboud B, El Hachem J, Yazbeck T, Doumit C (2009) Hepatic portal venous gas: physiopathology, etiology, prognosis and treatment. World J Gastroenterol 15(29):3585\u20133590. https:\/\/doi.org\/10.3748\/wjg.15.3585","journal-title":"World J Gastroenterol"},{"issue":"6","key":"2472_CR12","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1590\/1806-9282.64.06.543","volume":"64","author":"S Ko","year":"2018","unstructured":"Ko S, Hong SS, Hwang J, Kim H, Chang YW, Lee E (2018) Benign versus life-threatening causes of pneumatosis intestinalis: differentiating CT features. Rev Assoc Med Bras 64(6):543\u2013548. https:\/\/doi.org\/10.1590\/1806-9282.64.06.543","journal-title":"Rev Assoc Med Bras"},{"issue":"5","key":"2472_CR13","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.2214\/AJR.12.8942","volume":"200","author":"KS Lee","year":"2013","unstructured":"Lee KS, Hwang S, R\u00faa SMH, Janjigian YY, Gollub MJ (2013) Distinguishing benign and life-threatening pneumatosis intestinalis in patients with cancer by CT imaging features. AJR Am J Roentgenol 200(5):1042\u20131047. https:\/\/doi.org\/10.2214\/AJR.12.8942","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"2472_CR14","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1148\/radiol.2263011540","volume":"226","author":"W Wiesner","year":"2003","unstructured":"Wiesner W, Khurana B, Ji H, Ros PR (2003) CT of acute bowel ischemia. Radiology 226(3):635\u2013650. https:\/\/doi.org\/10.1148\/radiol.2263011540","journal-title":"Radiology"},{"issue":"1","key":"2472_CR15","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1007\/s00330-016-4348-9","volume":"27","author":"MO Treyaud","year":"2017","unstructured":"Treyaud MO, Duran R, Zins M, Knebel JF, Meuli RA, Schmidt S (2017) Clinical significance of pneumatosis intestinalis \u2013 correlation of MDCT-findings with treatment and outcome. Eur Radiol 27(1):70\u201379. https:\/\/doi.org\/10.1007\/s00330-016-4348-9","journal-title":"Eur Radiol"},{"issue":"6","key":"2472_CR16","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1016\/j.rcl.2015.06.009","volume":"53","author":"HS Dhatt","year":"2015","unstructured":"Dhatt HS, Behr SC, Miracle A, Wang ZJ, Yeh BM (2015) Radiological evaluation of bowel ischemia. Radiol Clin North Am 53(6):1241\u20131254. https:\/\/doi.org\/10.1016\/j.rcl.2015.06.009","journal-title":"Radiol Clin North Am"},{"issue":"4","key":"2472_CR17","doi-asserted-by":"publisher","first-page":"2792","DOI":"10.1007\/s00330-022-09258-5","volume":"33","author":"Y Zeng","year":"2022","unstructured":"Zeng Y, Yang F, Hu X, Zhu F, Chen W, Lin W (2022) Radiological predictive factors of transmural intestinal necrosis in acute mesenteric ischemia: systematic review and meta-analysis. Eur Radiol 33(4):2792\u20132799. https:\/\/doi.org\/10.1007\/s00330-022-09258-5","journal-title":"Eur Radiol"},{"issue":"1","key":"2472_CR18","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/TA.0b013e318298486e","volume":"75","author":"JJ DuBose","year":"2013","unstructured":"DuBose JJ, Lissauer M, Maung AA et al (2013) Pneumatosis intestinalis predictive evaluation study (PIPES). J Trauma Acute Care Surg 75(1):15\u201323. https:\/\/doi.org\/10.1097\/TA.0b013e318298486e","journal-title":"J Trauma Acute Care Surg"},{"key":"2472_CR19","doi-asserted-by":"publisher","unstructured":"Rigiroli F, Nakhaei M, Karam R et al. (2025) Combining clinical and radiological features improves prediction of bowel ischemia in patients with CT findings of pneumatosis intestinalis. Abdominal Radiol. Published online January 28, 2025. https:\/\/doi.org\/10.1007\/s00261-025-04814-1","DOI":"10.1007\/s00261-025-04814-1"},{"issue":"01","key":"2472_CR20","doi-asserted-by":"publisher","first-page":"049","DOI":"10.1055\/s-0040-1718251","volume":"04","author":"AR Patil","year":"2021","unstructured":"Patil AR, Nandikoor S, Jagannath P, Bansal A (2021) Not just fat: imaging in abdominal fat pathology. J Gastrointest Abdom Radiol 04(01):049\u2013057. https:\/\/doi.org\/10.1055\/s-0040-1718251","journal-title":"J Gastrointest Abdom Radiol"},{"issue":"1","key":"2472_CR21","doi-asserted-by":"publisher","first-page":"W1","DOI":"10.2214\/AJR.10.4375","volume":"197","author":"E Thornton","year":"2011","unstructured":"Thornton E, Mendiratta-Lala M, Siewert B, Eisenberg RL (2011) Patterns of fat stranding. AJR Am J Roentgenol 197(1):W1\u2013W14. https:\/\/doi.org\/10.2214\/AJR.10.4375","journal-title":"AJR Am J Roentgenol"},{"issue":"2","key":"2472_CR22","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1148\/radiol.2532090168","volume":"253","author":"DE Olson","year":"2009","unstructured":"Olson DE, Kim YW, Ying J, Donnelly LF (2009) CT predictors for differentiating benign and clinically worrisome pneumatosis intestinalis in children beyond the neonatal period. Radiology 253(2):513\u2013519. https:\/\/doi.org\/10.1148\/radiol.2532090168","journal-title":"Radiology"},{"issue":"4","key":"2472_CR23","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.mcna.2009.03.007","volume":"93","author":"W Hou","year":"2009","unstructured":"Hou W, Sanyal AJ (2009) Ascites: diagnosis and management. Med Clin North Am 93(4):801\u2013817. https:\/\/doi.org\/10.1016\/j.mcna.2009.03.007","journal-title":"Med Clin North Am"},{"issue":"40","key":"2472_CR24","doi-asserted-by":"publisher","first-page":"e22461","DOI":"10.1097\/MD.0000000000022461","volume":"99","author":"W Adachi","year":"2020","unstructured":"Adachi W, Matsushita T, Yashiro Y, Imura J, Shiozawa H, Kishimoto K (2020) Clinical characteristics of pneumoperitoneum with pneumatosis intestinalis detected using computed tomography. Medicine 99(40):e22461. https:\/\/doi.org\/10.1097\/MD.0000000000022461","journal-title":"Medicine"},{"issue":"7","key":"2472_CR25","doi-asserted-by":"publisher","first-page":"2638","DOI":"10.1097\/00003246-200007000-00078","volume":"28","author":"RA Mularski","year":"2000","unstructured":"Mularski RA, Sippel JM, Osborne ML (2000) Pneumoperitoneum: a review of nonsurgical causes. Crit Care Med 28(7):2638\u20132644. https:\/\/doi.org\/10.1097\/00003246-200007000-00078","journal-title":"Crit Care Med"},{"issue":"3","key":"2472_CR26","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1097\/TA.0000000000001360","volume":"82","author":"P Ferrada","year":"2017","unstructured":"Ferrada P, Callcut R, Bauza G et al (2017) Pneumatosis intestinalis predictive evaluation study. J Trauma Acute Care Surg 82(3):451\u2013460. https:\/\/doi.org\/10.1097\/TA.0000000000001360","journal-title":"J Trauma Acute Care Surg"},{"issue":"3","key":"2472_CR27","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1097\/TA.0000000000002989","volume":"90","author":"CJ Rieser","year":"2021","unstructured":"Rieser CJ, Dadashzadeh ER, Handzel RM et al (2021) Development and validation of a five-factor score for prediction of pathologic pneumatosis. J Trauma Acute Care Surg 90(3):477\u2013483. https:\/\/doi.org\/10.1097\/TA.0000000000002989","journal-title":"J Trauma Acute Care Surg"},{"issue":"2","key":"2472_CR28","doi-asserted-by":"publisher","first-page":"167","DOI":"10.3390\/jpm14020167","volume":"14","author":"G Perrone","year":"2024","unstructured":"Perrone G, Giuffrida M, Donato V et al (2024) The challenge of pneumatosis intestinalis: a contemporary systematic review. J Pers Med 14(2):167. https:\/\/doi.org\/10.3390\/jpm14020167","journal-title":"J Pers Med"},{"issue":"5","key":"2472_CR29","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1097\/TA.0000000000004548","volume":"98","author":"J Song","year":"2025","unstructured":"Song J, Zhang B, Mahvi D et al (2025) Teasing out factors differentiating pathologic from benign pneumatosis intestinalis. J Trauma Acute Care Surg 98(5):806\u2013815. https:\/\/doi.org\/10.1097\/TA.0000000000004548","journal-title":"J Trauma Acute Care Surg"},{"issue":"1","key":"2472_CR30","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s13017-022-00443-x","volume":"17","author":"M Bala","year":"2022","unstructured":"Bala M, Catena F, Kashuk J et al (2022) Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery. World J Emergency Surg 17(1):54. https:\/\/doi.org\/10.1186\/s13017-022-00443-x","journal-title":"World J Emergency Surg"},{"issue":"24","key":"2472_CR31","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.1056\/NEJMra1309483","volume":"371","author":"JA Kraut","year":"2014","unstructured":"Kraut JA, Madias NE (2014) Lactic acidosis. N Engl J Med 371(24):2309\u20132319. https:\/\/doi.org\/10.1056\/NEJMra1309483","journal-title":"N Engl J Med"},{"issue":"10","key":"2472_CR32","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1007\/s11605-007-0241-9","volume":"11","author":"AJ Greenstein","year":"2007","unstructured":"Greenstein AJ, Nguyen SQ, Berlin A et al (2007) Pneumatosis intestinalis in adults: management, surgical indications, and risk factors for mortality. J Gastrointest Surg 11(10):1268\u20131274. https:\/\/doi.org\/10.1007\/s11605-007-0241-9","journal-title":"J Gastrointest Surg"},{"issue":"5","key":"2472_CR33","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1001\/archsurg.2011.95","volume":"146","author":"VP Duron","year":"2011","unstructured":"Duron VP, Rutigliano S, Machan JT, Dupuy DE, Mazzaglia PJ (2011) Computed tomographic diagnosis of pneumatosis intestinalis. Arch Surg 146(5):506. https:\/\/doi.org\/10.1001\/archsurg.2011.95","journal-title":"Arch Surg"},{"issue":"1","key":"2472_CR34","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1148\/radiology.207.1.9530294","volume":"207","author":"BL Pear","year":"1998","unstructured":"Pear BL (1998) Pneumatosis intestinalis: a review. Radiology 207(1):13\u201319. https:\/\/doi.org\/10.1148\/radiology.207.1.9530294","journal-title":"Radiology"},{"issue":"1","key":"2472_CR35","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.bpg.2017.01.004","volume":"31","author":"JPM Derikx","year":"2017","unstructured":"Derikx JPM, Schellekens DHSM, Acosta S (2017) Serological markers for human intestinal ischemia: A systematic review. Best Pract Res Clin Gastroenterol 31(1):69\u201374. https:\/\/doi.org\/10.1016\/j.bpg.2017.01.004","journal-title":"Best Pract Res Clin Gastroenterol"},{"issue":"3","key":"2472_CR36","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/j.1445-5994.2011.02557.x","volume":"42","author":"A Balbir-Gurman","year":"2012","unstructured":"Balbir-Gurman A, Brook OR, Chermesh I, Braun-Moscovici Y (2012) Pneumatosis cystoides intestinalis in scleroderma-related conditions. Intern Med J 42(3):323\u2013329. https:\/\/doi.org\/10.1111\/j.1445-5994.2011.02557.x","journal-title":"Intern Med J"},{"key":"2472_CR37","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1194721","author":"J Liu","year":"2023","unstructured":"Liu J, Zhang L, Chen S, Lu X, Li S (2023) Pneumatosis cystoides intestinalis in dermatomyositis: a case series report and literature review. Front Immunol. https:\/\/doi.org\/10.3389\/fimmu.2023.1194721","journal-title":"Front Immunol"},{"issue":"10","key":"2472_CR38","first-page":"1747","volume":"90","author":"Y Heng","year":"1995","unstructured":"Heng Y, Schuffler MD, Haggitt RC, Rohrmann CA (1995) Pneumatosis intestinalis: a review. Am J Gastroenterol 90(10):1747\u20131758","journal-title":"Am J Gastroenterol"},{"issue":"19","key":"2472_CR39","doi-asserted-by":"publisher","first-page":"17597","DOI":"10.1007\/s00432-023-05461-z","volume":"149","author":"G Sperling","year":"2023","unstructured":"Sperling G, Shatila M, Varatharajalu K et al (2023) Pneumatosis intestinalis in cancer patients who received immune checkpoint inhibitors. J Cancer Res Clin Oncol 149(19):17597\u201317605. https:\/\/doi.org\/10.1007\/s00432-023-05461-z","journal-title":"J Cancer Res Clin Oncol"},{"key":"2472_CR40","doi-asserted-by":"publisher","first-page":"175628481987091","DOI":"10.1177\/1756284819870911","volume":"12","author":"RC Pezo","year":"2019","unstructured":"Pezo RC, Wong M, Martin A (2019) Impact of the gut microbiota on immune checkpoint inhibitor-associated toxicities. Therap Adv Gastroenterol 12:1756284819870911. https:\/\/doi.org\/10.1177\/1756284819870911","journal-title":"Therap Adv Gastroenterol"},{"issue":"7","key":"2472_CR41","doi-asserted-by":"publisher","first-page":"1666","DOI":"10.3390\/cancers14071666","volume":"14","author":"G Gazzaniga","year":"2022","unstructured":"Gazzaniga G, Villa F, Tosi F et al (2022) Pneumatosis intestinalis induced by anticancer treatment: a systematic review. Cancers (Basel) 14(7):1666. https:\/\/doi.org\/10.3390\/cancers14071666","journal-title":"Cancers (Basel)"},{"issue":"3","key":"2472_CR42","doi-asserted-by":"publisher","first-page":"e55972","DOI":"10.7759\/cureus.55972","volume":"16","author":"CD Calenda","year":"2024","unstructured":"Calenda CD, Toohey CR, Levy M et al (2024) Pneumatosis intestinalis, pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum, and pneumobilia after pembrolizumab therapy: a case report. Cureus 16(3):e55972. https:\/\/doi.org\/10.7759\/cureus.55972","journal-title":"Cureus"},{"issue":"10S","key":"2472_CR43","doi-asserted-by":"publisher","first-page":"S2530","DOI":"10.14309\/01.ajg.0001044872.27147.4e","volume":"119","author":"A Dadlani","year":"2024","unstructured":"Dadlani A, Schwartz MR, Fan C, Mathur N (2024) S3876\u2003rare case of immune checkpoint inhibitor colitis manifesting as pneumatosis intestinalis. Am J Gastroenterol 119(10S):S2530\u2013S2530. https:\/\/doi.org\/10.14309\/01.ajg.0001044872.27147.4e","journal-title":"Am J Gastroenterol"},{"key":"2472_CR44","doi-asserted-by":"publisher","first-page":"1133551","DOI":"10.3389\/fphar.2023.1133551","volume":"14","author":"T Zhang","year":"2023","unstructured":"Zhang T, Cao M, Zhao B et al (2023) Pneumatosis intestinalis post steroid use in a patient with immune-related adverse events: Case report, literature review and FAERS analysis. Front Pharmacol 14:1133551. https:\/\/doi.org\/10.3389\/fphar.2023.1133551","journal-title":"Front Pharmacol"},{"issue":"3","key":"2472_CR45","doi-asserted-by":"publisher","first-page":"1984","DOI":"10.21037\/jtd.2018.02.52","volume":"10","author":"V Gemma","year":"2018","unstructured":"Gemma V, Mistrot D, Row D et al (2018) Pneumatosis intestinalis in solid organ transplant recipients. J Thorac Dis 10(3):1984\u20131997. https:\/\/doi.org\/10.21037\/jtd.2018.02.52","journal-title":"J Thorac Dis"},{"issue":"6","key":"2472_CR46","doi-asserted-by":"publisher","first-page":"e14654","DOI":"10.1111\/ctr.14654","volume":"36","author":"D Atwood","year":"2022","unstructured":"Atwood D, Nelson A, Rosen R, Esteso P, Visner G, Midyat L (2022) Pneumatosis intestinalis after thoracic organ transplantation in children: a case series and review of the literature. Clin Transplant 36(6):e14654. https:\/\/doi.org\/10.1111\/ctr.14654","journal-title":"Clin Transplant"},{"issue":"11","key":"2472_CR47","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1038\/bmt.2014.148","volume":"49","author":"PK Bhamidipati","year":"2014","unstructured":"Bhamidipati PK, Ghobadi A, Bauer S, DiPersio JF, Pusic I (2014) Conservative management of pneumatosis intestinalis after allogeneic hematopoietic SCT. Bone Marrow Transplant 49(11):1436\u20131438. https:\/\/doi.org\/10.1038\/bmt.2014.148","journal-title":"Bone Marrow Transplant"},{"issue":"5","key":"2472_CR48","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1177\/00031348211060454","volume":"88","author":"C Castater","year":"2022","unstructured":"Castater C, Gliga LA, Meyer C, Hazen B, Greene W, Fiza B (2022) Successful non-operative management of extensive pneumatosis cystoides intestinalis due to graft versus host disease. Am Surg 88(5):1000\u20131002. https:\/\/doi.org\/10.1177\/00031348211060454","journal-title":"Am Surg"},{"issue":"1","key":"2472_CR49","doi-asserted-by":"publisher","first-page":"20160017","DOI":"10.1259\/bjrcr.20160017","volume":"3","author":"C Sassi","year":"2017","unstructured":"Sassi C, Pasquali M, Facchini G, Bazzocchi A, Battista G (2017) Pneumatosis intestinalis in oncologic patients: when should the radiologist not be afraid? BJR|Case Reports 3(1):20160017. https:\/\/doi.org\/10.1259\/bjrcr.20160017","journal-title":"BJR|Case Reports"},{"issue":"3","key":"2472_CR50","doi-asserted-by":"publisher","first-page":"497","DOI":"10.51821\/84.3.015","volume":"84","author":"S Brocchi","year":"2021","unstructured":"Brocchi S, Parmeggiani A, Gaudiano C et al (2021) Pneumatosis intestinalis and spontaneous perforation associated with drug toxicity in oncologic patients: a case series. Acta Gastroenterol Belg 84(3):497\u2013499. https:\/\/doi.org\/10.51821\/84.3.015","journal-title":"Acta Gastroenterol Belg"},{"issue":"6","key":"2472_CR51","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.2214\/AJR.12.8782","volume":"199","author":"AB Shinagare","year":"2012","unstructured":"Shinagare AB, Howard SA, Krajewski KM, Zukotynski KA, Jagannathan JP, Ramaiya NH (2012) Pneumatosis intestinalis and bowel perforation associated with molecular targeted therapy: an emerging problem and the role of radiologists in its management. AJR Am J Roentgenol 199(6):1259\u20131265. https:\/\/doi.org\/10.2214\/AJR.12.8782","journal-title":"AJR Am J Roentgenol"},{"issue":"1","key":"2472_CR52","doi-asserted-by":"publisher","first-page":"75","DOI":"10.6002\/ect.2016.0289","volume":"16","author":"R Chandola","year":"2018","unstructured":"Chandola R, Laing B, Lien D, Mullen J (2018) Pneumatosis intestinalis and its association with lung transplant: Alberta experience. Exp Clin Transplant 16(1):75\u201380. https:\/\/doi.org\/10.6002\/ect.2016.0289","journal-title":"Exp Clin Transplant"},{"issue":"5","key":"2472_CR53","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1016\/j.amjsurg.2008.01.011","volume":"195","author":"MS Morris","year":"2008","unstructured":"Morris MS, Gee AC, Cho SD et al (2008) Management and outcome of pneumatosis intestinalis. Am J Surg 195(5):679\u2013682. https:\/\/doi.org\/10.1016\/j.amjsurg.2008.01.011. discussion 682-3","journal-title":"Am J Surg"},{"key":"2472_CR54","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.ijscr.2014.12.007","volume":"6C","author":"M Tahiri","year":"2015","unstructured":"Tahiri M, Levy J, Alzaid S, Anderson D (2015) An approach to pneumatosis intestinalis: factors affecting your management. Int J Surg Case Rep 6C:133\u2013137. https:\/\/doi.org\/10.1016\/j.ijscr.2014.12.007","journal-title":"Int J Surg Case Rep"},{"issue":"4","key":"2472_CR55","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/j.ejrad.2014.01.003","volume":"83","author":"HS Lee","year":"2014","unstructured":"Lee HS, Cho YW, Kim KJ, Lee JS, Lee SS, Yang SK (2014) A simple score for predicting mortality in patients with pneumatosis intestinalis. Eur J Radiol 83(4):639\u2013645. https:\/\/doi.org\/10.1016\/j.ejrad.2014.01.003","journal-title":"Eur J Radiol"},{"issue":"14","key":"2472_CR56","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.3748\/wjg.v26.i14.1628","volume":"26","author":"M Gonda","year":"2020","unstructured":"Gonda M, Osuga T, Ikura Y, Hasegawa K, Kawasaki K, Nakashima T (2020) Optimal treatment strategies for hepatic portal venous gas: a retrospective assessment. World J Gastroenterol 26(14):1628\u20131637. https:\/\/doi.org\/10.3748\/wjg.v26.i14.1628","journal-title":"World J Gastroenterol"},{"key":"2472_CR57","doi-asserted-by":"publisher","first-page":"e937197","DOI":"10.12659\/AJCR.937197","volume":"23","author":"C Zhou","year":"2022","unstructured":"Zhou C, Kilpatrick MD, Williams JB, Rivers JF, Miller TA (2022) Hepatic portal venous gas: a potentially lethal sign demanding urgent management. Am J Case Rep 23:e937197. https:\/\/doi.org\/10.12659\/AJCR.937197","journal-title":"Am J Case Rep"},{"issue":"5","key":"2472_CR58","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1001\/archsurg.2011.95","volume":"146","author":"VP Duron","year":"2011","unstructured":"Duron VP, Rutigliano S, Machan JT, Dupuy DE, Mazzaglia PJ (2011) Computed tomographic diagnosis of pneumatosis intestinalis: clinical measures predictive of the need for surgical intervention. Arch Surg 146(5):506\u2013510","journal-title":"Arch Surg"},{"key":"2472_CR59","doi-asserted-by":"publisher","first-page":"101995","DOI":"10.1016\/j.epsc.2021.101995","volume":"73","author":"SN Acker","year":"2021","unstructured":"Acker SN, Ogle S, Saifee J, Marks L, Kulungowski AM (2021) Surgical management of recurrent idiopathic pneumatosis intestinalis in the pediatric population. J Pediatr Surg Case Rep 73:101995","journal-title":"J Pediatr Surg Case Rep"},{"key":"2472_CR60","doi-asserted-by":"publisher","unstructured":"Lasinski AM, Posluszny J, Luchette FA (2017) Small Bowel: Pneumatosis Intestinalis. In: Complications in Acute Care Surgery. Springer International Publishing;2017 165\u2013171. https:\/\/doi.org\/10.1007\/978-3-319-42376-0_13","DOI":"10.1007\/978-3-319-42376-0_13"},{"issue":"3","key":"2472_CR61","doi-asserted-by":"publisher","first-page":"e28588","DOI":"10.1097\/MD.0000000000028588","volume":"101","author":"Q Zhang","year":"2022","unstructured":"Zhang Q, Niu X, Wang C, He Q, Xiang J (2022) Pneumatosis cystoides intestinalis. Medicine 101(3):e28588. https:\/\/doi.org\/10.1097\/MD.0000000000028588","journal-title":"Medicine"},{"issue":"1","key":"2472_CR62","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1186\/s12876-019-1087-9","volume":"19","author":"F Ling","year":"2019","unstructured":"Ling F, Guo D, Zhu L (2019) Pneumatosis cystoides intestinalis: a case report and literature review. BMC Gastroenterol 19(1):176. https:\/\/doi.org\/10.1186\/s12876-019-1087-9","journal-title":"BMC Gastroenterol"},{"issue":"1","key":"2472_CR63","doi-asserted-by":"publisher","first-page":"81","DOI":"10.4266\/acc.2016.00311","volume":"34","author":"DJ Kim","year":"2019","unstructured":"Kim DJ, Choi YJ, Yoo YS (2019) Pneumatosis intestinalis presenting as small bowel obstruction without bowel ischemia after mechanical ventilation. Acute Crit Care 34(1):81\u201385. https:\/\/doi.org\/10.4266\/acc.2016.00311","journal-title":"Acute Crit Care"},{"issue":"1","key":"2472_CR64","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.yasu.2025.05.004","volume":"59","author":"J Mather","year":"2025","unstructured":"Mather J, Diaz J (2025) Pneumatosis intestinalis in adults. Adv Surg 59(1):143\u2013160. https:\/\/doi.org\/10.1016\/j.yasu.2025.05.004","journal-title":"Adv Surg"},{"issue":"6","key":"2472_CR65","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1186\/2047-783x-14-6-231","volume":"14","author":"PN Khalil","year":"2009","unstructured":"Khalil PN, Huber-Wagner S, Ladurner R et al (2009) Natural history, clinical pattern, and surgical considerations of pneumatosis intestinalis. Eur J Med Res 14(6):231\u2013239. https:\/\/doi.org\/10.1186\/2047-783x-14-6-231","journal-title":"Eur J Med Res"},{"key":"2472_CR66","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.ijscr.2014.12.007","volume":"6","author":"M Tahiri","year":"2015","unstructured":"Tahiri M, Levy J, Alzaid S, Anderson D (2015) An approach to pneumatosis intestinalis: factors affecting your management. Int J Surg Case Rep 6:133\u2013137. https:\/\/doi.org\/10.1016\/j.ijscr.2014.12.007","journal-title":"Int J Surg Case Rep"},{"issue":"5","key":"2472_CR67","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1016\/j.mayocp.2014.01.026","volume":"89","author":"JD Feuerstein","year":"2014","unstructured":"Feuerstein JD, White N, Berzin TM (2014) Pneumatosis intestinalis with a focus on hyperbaric oxygen therapy. Mayo Clin Proc 89(5):697\u2013703. https:\/\/doi.org\/10.1016\/j.mayocp.2014.01.026","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"2472_CR68","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1148\/radiol.10092129","volume":"258","author":"JM Torrisi","year":"2011","unstructured":"Torrisi JM, Schwartz LH, Gollub MJ, Ginsberg MS, Bosl GJ, Hricak H (2011) CT findings of chemotherapy-induced toxicity: what radiologists need to know about the clinical and radiologic manifestations of chemotherapy toxicity. Radiology 258(1):41\u201356. https:\/\/doi.org\/10.1148\/radiol.10092129","journal-title":"Radiology"},{"key":"2472_CR69","doi-asserted-by":"publisher","first-page":"214236","DOI":"10.1155\/2015\/214236","volume":"2015","author":"JA Miller","year":"2015","unstructured":"Miller JA, Ford DJ, Ahmed MS, Loree TR (2015) Two cases of pneumatosis intestinalis during Cetuximab therapy for advanced head and neck cancer. Case Rep Oncol Med 2015:214236. https:\/\/doi.org\/10.1155\/2015\/214236","journal-title":"Case Rep Oncol Med"},{"issue":"28","key":"2472_CR70","doi-asserted-by":"publisher","first-page":"3739","DOI":"10.3748\/wjg.v28.i28.3739","volume":"28","author":"SSN Goh","year":"2022","unstructured":"Goh SSN, Shelat V (2022) Prednisolone induced pneumatosis coli and pneumoperitoneum. World J Gastroenterol 28(28):3739\u20133742. https:\/\/doi.org\/10.3748\/wjg.v28.i28.3739","journal-title":"World J Gastroenterol"},{"issue":"36","key":"2472_CR71","doi-asserted-by":"publisher","first-page":"4073","DOI":"10.1200\/JCO.21.01440","volume":"39","author":"BJ Schneider","year":"2021","unstructured":"Schneider BJ, Naidoo J, Santomasso BD et al (2021) Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update. J Clin Oncol 39(36):4073\u20134126. https:\/\/doi.org\/10.1200\/JCO.21.01440","journal-title":"J Clin Oncol"}],"container-title":["Emergency Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-026-02472-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10140-026-02472-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10140-026-02472-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T03:47:47Z","timestamp":1785728867000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10140-026-02472-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,2]]},"references-count":71,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["2472"],"URL":"https:\/\/doi.org\/10.1007\/s10140-026-02472-4","relation":{},"ISSN":["1438-1435"],"issn-type":[{"value":"1438-1435","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,2]]},"assertion":[{"value":"18 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interests.","order":2,"name":"Ethics","label":"Conflict of interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}