Is pneumorrhachis a poor prognostic sign in acute gangrenous abdominal emergencies?

Pneumorrhachis (air in the spinal canal) is an uncommon radiological finding. Its detection in gangrenous abdominal emergencies is rarer with uncertain prognostic significance. We illustrate the computed tomography features and assess the patient outcomes in two cases of pneumorrhachis identified in gangrenous pathologies of the abdomen (emphysematous pyelonephritis and bowel gangrene). Patient outcome was poor in the current and previously reported cases. Pneumorrhachis could be an additional imaging sign of poor prognosis in acute gangrenous abdominal emergencies.