Intramural gas

The presence of gas within the wall of a hollow viscus, most commonly the gastrointestinal tract. Clinical severity ranges from an incidental benign finding to a life-threatening condition associated with ischemia, infection, or mucosal injury.

Causes

• Life-threatening gastrointestinal conditions causing mucosal disruption

  • Bowel ischemia

  • Intestinal infarction

  • Necrotizing enterocolitis

  • Mechanical bowel obstruction

  • Perforated peptic ulcer

  • Perforated diverticulitis

  • Severe gastrointestinal infection

  • Abdominal trauma

  • Sepsis-related bowel injury

  • Gas-producing bacterial infection

• Pulmonary conditions causing increased alveolar pressure and gas tracking into the mediastinum or gastrointestinal wall

  • Asthma

  • Chronic obstructive pulmonary disease (COPD)

  • Interstitial pneumonia

• Autoimmune disease causing intestinal dysmotility or mucosal damage

  • Scleroderma

  • Systemic lupus erythematosus (SLE)

• Medications causing mucosal fragility or immune suppression

  • Corticosteroids

  • Immunosuppressive therapies

  • Chemotherapy

• Iatrogenic procedures causing increased intraluminal pressure or mucosal injury

  • Endoscopy

  • Colonoscopy

• Chronic constipation

• Benign idiopathic cases