Pneumatosis cystoides intestinalis is an uncommon condition characterized by gas filled cysts within the bowel wall. We present a case of a 40-year old male who complained of abdominal pain and distension. The clinical diagnosis was intestinal obstruction and intraoperative impression was intestinal lymphangioma. The resected segment of the bowel showed multiple thin walled, tense, air-filled cysts on the serosal surface, which collapsed with a popping sound when pricked. The histologic diagnosis was pneumatosis cystoides intestinalis. Pneumatosis cystoides intestinalis has varied clinical manifestations, course and outcome depending on its benign or fulminant form. There are varying theories regarding its pathogenesis and it is seen in association with a variety of diseases. Hence it should be interpreted with relevance to its entire clinical context, as it may not be a disease in itself but a sequel to other conditions.
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