We present a case of a 74-year-old-woman who developed 3 episodes of i
ntestinal pneumatosis, 2 times complicated by pneumoperitoneum, with c
onsequent lethal outcome after 4 months. Intestinal pneumatosis, accor
ding to the literature, is a difficult and rare problem, associated wi
th a large number of current diseases, can be complicated by pneumoper
itoneum, mostly without clear etiology, whose treatment remains empiri
cal (antibiotics, O2-therapy), not excluded laparotomy, if the clinica
l situation requires it.