A 64-year-old woman was admitted to our hospital for a closer examination of occult blood in the stool. She appeared to be healthy, but physical examination revealed a soft elastic mass in her right lower abdomen. Laboratory examinations showed no abnormality of blood chemistry and that red and white blood cell counts were within the normal ranges. Abdominal X-ray revealed numerous round radiolucencies in the right side of the colon (figure 1), which were shown as honeycomb-like lesions by computed tomography. Total colonoscopy showed multiple submucosal cysts containing gas in the ascending and transverse colons (figure 2). She was therefore diagnosed as having pnematosis cystoides intestinalis.

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Figure 1

Abdominal X-ray

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Figure 2

Colonoscopic findings of the transverse colon

 We should bear in mind that pnematosis cystoides intestinalis can be easily diagnosed by the characteristic numerous round radiolucencies on abdominal X-ray, which can eliminate unnecessary invasive and expensive further examinations.