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The causes of pneumobilia include an incompetent Sphincter of Oddi (e.g. post sphincterotomy, or following passage of a gallstone), gallstone ileus, trauma, a duodenal ulcer perforating into the common bile duct, and secondary to surgery (e.g. cholecystoenterostomy).
Symptoms include the following, according to the cause of the pneumothorax: 1  Spontaneous pneumothorax. Simple spontaneous pneumothorax is caused by a rupture of a small air sac or fluid-filled sac in the lung. 2  Tension pneumothorax. Following trauma, air may enter the chest cavity.