A rare case of pneumobilia following blunt abdominal trauma in a patient with pneumatosis cystoides intestinalis

Abstract

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by gas-filled cysts within the gastrointestinal wall, often discovered incidentally or presenting with abdominal pain and pneumoperitoneum. Pneumobilia following blunt trauma is an even rarer finding, typically associated with increased intra-abdominal pressure. We report the case of a 46-year-old male with no significant medical history who sustained a 5-meter fall. The CT scan revealed pneumobilia, pneumoperitoneum, and areas of pneumatosis intestinalis in the small intestine, suggesting PCI with cyst rupture and retrograde air passage into the biliary ducts. The patient was managed conservatively with close monitoring, and symptoms resolved completely within 5 days. This case highlights the importance of distinguishing PCI from life-threatening conditions such as bowel ischemia to avoid unnecessary surgical interventions, emphasizing the role of imaging in guiding appropriate management.