Pneumatosis cystoides intestinalis manifested by pneumoperitoneum

: We report the case of a female patient, suffering from chronic respiratory insufficiency and treated with steroids, in whom the discovery of pneumoperitoneum led to exploratory laparotomy. The plain abdominal X-rays demonstrated gas in the walls of the stomach as well as in the peritoneal cavity. Intraoperative exploration revealed the existence of pneumatosis cystoides of the stomach and small intestine. This observation is a reminder that not all cases of pneumoperitoneum are surgical, and notably this is the case for cystic intestinal pneumatosis.