BMJ Case Reports 2012; doi:10.1136/bcr-2012-006720
  • Unusual presentation of more common disease/injury

Pneumatosis intestinalis in a patient with recurrent Clostridium difficile infection

  1. Chung-Jyi Tsai2
  1. 1Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA
  2. 2Department of Gastroenterology and Hepatology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
  1. Correspondence to Dr Duc Ha, had{at}


A 65-year-old man with long-standing diarrhoea, recurrent Clostridium difficile infection (CDI) in the previous 5 months presented to the gastroenterology clinic with recurrent diarrhoea and abdominal cramping. Physical examination was negative for signs of acute abdomen. Stool C difficile PCR was positive. Abdominal imaging demonstrated an extensive pneumatosis intestinalis involving the small bowel and a dilated small bowel loop. He was treated conservatively with oral vancomycin for recurrent CDI with resolution of diarrhoea and abdominal cramping on 1-month follow-up visit.

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