Intramural intestinal gas in adults.

It is important that a routine search be done roentgenographically for intramural intestinal gas. Several different patterns may be present, but unfortunately, classification of the findings is not helpful in predicting either the cause, or the presence, of gangrene. Also, the clinical circumstances in which intramural intestinal gas is discovered are important--if seen in a patient with acute pain in the abdomen, panmural gangrene is nearly always present and early operation desirable. However, if first discovered in the early postoperative period, a more selective approach is possible. Although many of the patients with intramural intestinal gas died, approximately one-quarter will survive. Hopefully, more timely recognition of intramural intestinal gas will allow earlier surgical intervention in some patients with ischemia of the intestine.