A Rare Cause of Postprandial Abdominal Pain and Nausea

Question: A 65-year old woman presents for evaluation of chronic postprandial abdominal pain and nausea. She first developed symptoms 3 years earlier with an associated 40-lb weight loss. Initial workup included upper and lower endoscopy, celiac serologies, computed tomography (CT) scan, and MR enterography, all unremarkable. She was trialed on acid suppressive therapy, antispasmodics, and antiemetics with little benefit, although nonabsorbable oral antibiotics did improve symptoms. After presenting with an acute exacerbation of symptoms, a CT scan showed focal pneumatosis of distal small bowel and pneumoperitoneum.
Source: Gastroenterology - Category: Gastroenterology Authors: Tags: Electronic Clinical Challenges and Images in GI Source Type: research