Air in the gut wall

Abstract

A 56-year-old female smoker with diabetes mellitus, hypercholesterolaemia, and obesity was admitted to the intensive care unit with septic shock, caused by a urinary-tract infection. She was treated with high doses of norepinephrine: up to 1·4 μg/kg/min. She developed severe abdominal pain. Abdominal radiography, with the patient supine, showed severe dilatation of the colon, and air in much of the colonic wall—ie, pneumatosis coli. After colectomy, histological examination of the colon showed widespread ischaemic colitis.