Pneumorrhachis with pneumocranium: an unusual complication of intra-abdominal sepsis.

We present this unusual case of a 60-year-old gentleman who presented with meningism and reduced conscious level. Imaging demonstrated a perforated sigmoid colon with retroperitoneal air associated with pneumorrhachis and pneumocranium. He required a Hartmann's procedure and broad spectrum intra-thecal antibiotics which led to resolution of the pneumorrhachis and pneumocranium.