[1][2] As a radiological sign it is highly suggestive for necrotizing enterocolitis.

This is in contrast to gas in the intestinal lumen (which is relieved by flatulence).

In newborns, pneumatosis intestinalis is considered diagnostic for necrotizing enterocolitis, and the gas is produced by bacteria in the bowel wall.

[3] The pathogenesis of pneumatosis intestinalis is poorly understood and is likely multifactorial.

In some cases, PI is an incidental finding, whereas in others, it portends a life-threatening intra-abdominal condition.