A clinical case of pneumatosis intestinalis in a patient with generalized tuberculosis and HIV co-infection

Pneumatosis intestinalis is a rare clinical condition characterised by the presence of extraluminal air accumulations in the intestinal wall.We present a clinical case of pneumatosis intestinalis in a 35-year-old female patient with HIV/TB coinfection, symptoms of acute intestinal obstruction and the presence of free gas in the abdominal cavity according to non-contrasted multispiral computed tomography (CT). According to the results of additional examination (abdominal CT with oral and intravenous bolus contrasting) it was possible to exclude life-threatening conditions (acute intestinal obstruction, bowel perforation, mesenteric thrombosis), to confirm the presence of pneumatosis intestinalis and to avoid unjustified surgical intervention.This clinical observation shows that detection of «free gas» symptom in the abdominal cavity on plain abdominal radiographs does not have 100% specificity in relation to acute surgical pathology, in some cases requiring the use of more accurate methods of investigation, including abdominal CT with oral and bolus intravenous contrasting.