HighlightsPneumatosis intestinalis can be benign or life-threatening.Life-threatening causes are bowel obstruction, perforation, ischemia and severe colitis.Differential diagnosis between life-threatening and benign pneumatosis intestinalis is difficult.Early severity recognition is critical as it would dictate surgical or conservative management.Surgery is needed when worrisome clinical, laboratory and imaging findings are present.

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Salvage surgery is an acceptable option for palliative treatment of thyroid bed recurrence in metastatic papillary thyroid carcinoma when other non-invasive options fail to control local skin complications.

Differential diagnosis between benign and life-threatening pneumatosis intesti-nalis poses a great dianostic dilemma.

Diagnosis of acute low back emergencies during a systemic lupus erythematosus flare necessitates high clinical suspicion and early CT.K E Y W O R D S exacerbation, myositis, necrosis, systemic lupus erythematosus F I G U R E 1 CT revealed enlargement of superficial and deep muscles of the right gluteal and posterior thigh compartment with decreased attenuation, massive intramuscular gas collection, and stranding of surrounding fat planes How to cite this article: Boulas KA, Nathanailidou M, Sitaridis K, Filippidis I, Tsiariglis I, Hatzigeorgiadis A. Intractable low back pain during acute exacerbation of systemic lupus erythematosus.