Skip to main content

Table 2 Differential diagnosis of intra-abdominal gas-filled cysts

From: Laparoscopic-assisted resection of a giant colonic diverticulum: a case report

Condition Age at presentation (years) Diagnostic investigation Distinguishing features
GCD >60 AXR, CT >4 cm in size, air filled cyst
    Usually arises from the sigmoid colon
    Anti-mesenteric border [2]
    Associated diverticular disease
    60% palpable abdominal mass [4]-[6]
Pneumatosis cystoides 30-50 [11] CT Usually asymptomatic
    Symptoms: abdominal distension, discomfort, mucoid stools
    15% primary/idiopathic
    85% secondary: IBD, diverticulosis, pulmonary disease
    Numerous small pockets within bowel wall
    Affects small and large bowel [11]
Meckels diverticulum <30 Tech99, CT 2% population, 95% asymptomatic
    <2 cm in length
    PR bleeding most common presenting symptom in children
    Other symptoms: abdominal obstruction, inflammation, intussusception, ulceration and perforation
    Contain all layers of bowel wall
    Anti-mesenteric border, within 100 cm of ileocaecal valve
Volvulus (caecal/sigmoid) >70 AXR, Sigmoidoscopy Associated bowel obstruction
    Redundant sigmoid colon, past history of chronic constipation
    Haustra visible on distended loop on AXR [12]
Duplication cysts <2 CT, USS, AXR Anywhere along GI tract, most common in ileum
    Can be single/multiple
    50% have associated anomalies
    Wide range of symptoms pending location
    Mesenteric side, elongated in shape
    90% Non-communicating with gut lumen
    All bowel layers [12]
Emphysematous cystitis >40 AXR, CT, USS Due to bacterial fermentation of urinary glucose
    Gas production in bladder lumen and wall
    Assoc with diabetes, neurogenic bladder, bladder outlet obstruction, recurrent urinary tract infections
    Symptoms include dysuria, frequency, pneumaturia
    Distended tympanic mass arising from pelvis
    Most commonly due to Escherichia coli
Emphysematous cholecystitis [12] >40 AXR, CT RUQ pain, vomiting, pyrexia +/- RUQ mass
    Increased risk with diabetes and gallstones
    Infection usually due to Clostridium perfringes
    More risk of gangrene and perforation than with acute cholecystitis
Intra-abdominal abscess - CT Source of intra-abdominal sepsis
    Swinging pyrexia
    Palpable mass