When You Don't Trust Your Gut: A Case of Pneumatosis Intestinalis in a Complex Geriatric Patient

Document Type

Conference Proceeding

Publication Date

10-11-2025

Abstract

An 80-year-old male with type 2 diabetes, pulmonary hypertension, heart failure with preserved ejection fraction, and colon cancer post-partial colectomy in 2021 presented with coffee-ground emesis over 24 hours. Though initially stable, he quickly decompensated and progressed to unresponsiveness and pulselessness. After CPR was initiated and ROSC was achieved, the patient remained in refractory shock that required multiple vasopressors. Abdominal CT revealed bowel ischemia, mesenteric and portal venous gas, and pneumatosis intestinalis. This case explores the pathophysiologic mechanisms behind pneumatosis intestinalis, including mechanical theories and predisposing comorbidities, while emphasizing airway interventions that may inadvertently affect intraluminal pressure.

Comments

American Society of Anesthesiologists, The Anesthesiology Annual Meeting, October 10-14, 2025, San Antonio, TX

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