Pneumatosis intestinalis in anorexia nervosa.

We have read the article by Pérez-Santiago L et al. on the conservative or surgical management of pneumatosis intestinalis (PI). Recently we saw a case of a 18-year-old female diagnosed with anorexia nervosa who presented due to general malaise, asthenia, and inability to walk following an episode of abdominal pain, vomiting and diarrhea (10-15 stools daily, some of them bloody). Physical examination revealed signs of malnutrition and dehydration, and a distended, tender abdomen with no signs of peritoneal irritation. Laboratory chemistry tests revealed macrocytic anemia and metabolic alkalosis. An abdominal CT scan showed pancolonic pneumatosis, with greater involvement of the cecum, ascending and transverse colon, as well as pneumoperitoneum and gas in branches of the superior mesenteric and portal veins.