Intramural Intestinal Gas in Infants

The recent case report by Friedman et al. (N.E.J.M. 282:796, 1970) of an infant in whom intramural gas in the “gut” developed, followed later by pneumoperitoneum, after an exchange transfusion brings up an important question about what course to follow when intramural gas is seen on x-ray examination of a neonate. When this condition has been noted in neonates it has been referred to as “pneumatosis intestinalis,”¹ but is quite different from the usually benign disease found in adults. It generally occurs in premature infants and those who have undergone an exchange transfusion, and is frequently associated.