A health check up in a 31-year-old man revealed free air under the diaphragm by a chest X-ray. The CT showed marked cystic emphysema along the small intestinal wall, as well as thickening and stenosis of the pyloric wall of stomach. Therefore, we suspected pneumatosis cystoides intestinalis (PCI) with stenosis of the pylorus. Since no perforation of the intestinal tract was diagnosed, it was preserved. Upper G.I. endoscopy showed H2 stage gastric ulcer in the posterior wall of the antrum. Eventually, a diagnosis of PCI with gastric ulcer and stenosis of the pylorus was, which we preserved. We report this rare case here.

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