We present the case of a 70-year-old man found to have pneumatosis of the small intestine. An abdominal computed tomography (CT) scan detected massive intramural air in the entire circumference of the small intestine without any venous gas. During emergency surgery, 80 cm of the small bowel was removed. The pathological findings of thrombi in the resected specimen thus indicated that surgical intervention should be immediately performed in patients with pneumatosis throughout the small intestine. CT was useful for confirming the presence of intramural gas in pneumatosis of the small intestine. The presence of a massive amount of intramural gas in the entire small intestine circumference on the CT findings is thus considered to be an early indication of bowel infarction.
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