Figure 11a. Cecal pneumatosis in a 47-year-old diabetic woman with fever and abdominal pain 2 months after pancreatic transplantation. She had undergone renal transplantation 5 years before this admission. (a) Axial T2-weighted single-shot fast SE image of the lower abdomen shows an air-fluid level in the lumen of the cecum (black arrowhead). A curvilinear area of low signal intensity that conforms to the wall of the cecum (arrows) represents pneumatosis. Part of the cecal wall appears as a thin line of intermediate signal intensity (white arrowhead) that separates the luminal air from the pneumatosis. (b) Axial gadolinium-enhanced 3D fat-saturated T1-weighted GRE image of the upper abdomen, obtained during the portal venous phase, shows lack of signal within the left portal vein (arrow) due to air in the portal vein. (c) Unenhanced CT scan shows the cecal pneumatosis (arrows) and cecal wall thickening (arrowhead); CT also showed the air in the left portal vein. At surgery, a perforated diverticulum was found in the cecum.