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PubMed1990

Pneumatosis cystoides intestinalis after organ transplantation.

Pneumatosis cystoides intestinalis (PCI) is a rare disorder of undetermined etiology which is associated with various medical and gastrointestinal conditions. Fewer than 50 cases of PCI occurring after organ transplantation have been reported in the transplant and surgical literature. All have occurred either after bone marrow, kidney, or liver transplantation. The etiology remains obscure but proposed factors include pretransplantation chemotherapy and radiotherapy, immunosuppressive therapy, graft-versus-host disease, opportunistic enteric infections, and a sympathetic reaction from an adjacent inflamed allograft. The patients are often mildly symptomatic, and asymptomatic pneumoperitoneum is seen not infrequently. If the patient does not have a serious underlying illness, then the prognosis is good, with spontaneous resolution occurring in most cases. We report the first case of PCI occurring after an orthoptic cardiac transplantation, and extensively review the literature of PCI occurring in the setting of organ transplantation. We conclude that PCI is often a benign and self-limited condition in this setting, and morbidity is usually related to another complication of transplantation. Even the presence of pneumoperitoneum usually is not associated with peritonitis, and most cases of PCI can be managed conservatively.

Cardiomyopathy, Dilated↗

PubMed1986

Pneumatosis cystoides intestinalis. A review of the literature.

Pneumatosis cystoides intestinalis is a condition in which submucosal or subserosal gas cysts are found in the wall of the small or large bowel. Both fulminant and benign forms exist. Fulminant pneumatosis cystoides intestinalis is associated with an acute bacterial process, sepsis, and necrosis of the bowel, while benign pneumatosis cystoides intestinalis can be totally asymptomatic and observed as an incidental finding at laparotomy. Many different causes of pneumatosis cystoides intestinalis have been proposed, including mechanical and bacterial causes. A review of the literature is presented with emphasis on the etiology of pneumatosis cystoides intestinalis, which probably can be attributed to bacterial and mechanical factors. Diagnosis and different forms of therapy and their efficacy are also discussed.

Animals↗

PubMed2002

Endosonographic diagnosis of pneumatosis cystoides intestinalis in infancy.

We report pneumatosis cystoides intestinalis in a 10-month-old girl who developed bloody diarrhea following chemotherapy for leukemia. The diagnosis was made only by colonic endoscopic ultrasonography, whereas the abdominal plain radiogram and computed tomography failed to elucidate the diagnosis. She was successfully treated with hyperbaric oxygen therapy. Wider application of endoscopic ultrasonography may lead to the more frequent detection of pneumatosis cystoides intestinalis, currently a rare disorder.

Endosonography↗

PubMed1976

Pneumatosis cystoides intestinalis in systemic sclerosis.

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of multiple gas containing thin walled cysts in the intestinal wall and mesentery. It is sometimes associated with chronic obstructive pulmonary disease, but has been described most often in patients with gastrointestinal disorders including duodenal and gastric ulceration, small bowel obstruction, regional enteritis and gastrointestinal malignancy. Its association in the patient described below with severe systemic sclerosis is of particular interest. There have been occasional previous reports of this association which should be considered in any patient with systemic sclerosis who develops abdominal symptoms suggestive of acute or sub-acute intestinal obstruction, not readily explicable by other causes.

Female↗

PubMedDate not supplied

Pneumatosis cystoides intestinalis: case reports and review of the literature.

Pneumatosis cystoides intestinalis is an uncommon condition in which submucosal or subserosal gas cysts are found in the wall of the small or large bowel. Many different causes of pneumatosis cystoides intestinalis have been proposed, including mechanical and bacterial causes. Approximately 85% of cases are thought to be secondary to coexisting disorders of the gastrointestinal tract or the respiratory system. Since 1986 we have observed 4 cases of pneumatosis cystoides intestinalis. A review of the literature is presented with emphasis on the etiology, diagnosis, differential diagnosis, and therapy of pneumatosis cystoides intestinalis. Symptoms of pneumatosis cystoides intestinalis include diarrhea, constipation, rectal bleeding, passage of mucus per rectum, vague abdominal discomfort, abdominal pain, urgency, malabsorption, weight loss, and excessive flatus. Depending on the location of the gas filled cysts the range of symptoms in each patient may vary enormously.

Aged↗

PubMed2003

Pneumatosis cystoides intestinalis: disease or sequel? A case report and review of theories regarding pathogenesis.

Pneumatosis cystoides intestinalis is an uncommon condition characterized by gas filled cysts within the bowel wall. We present a case of a 40-year old male who complained of abdominal pain and distension. The clinical diagnosis was intestinal obstruction and intraoperative impression was intestinal lymphangioma. The resected segment of the bowel showed multiple thin walled, tense, air-filled cysts on the serosal surface, which collapsed with a popping sound when pricked. The histologic diagnosis was pneumatosis cystoides intestinalis. Pneumatosis cystoides intestinalis has varied clinical manifestations, course and outcome depending on its benign or fulminant form. There are varying theories regarding its pathogenesis and it is seen in association with a variety of diseases. Hence it should be interpreted with relevance to its entire clinical context, as it may not be a disease in itself but a sequel to other conditions.

Adult↗

PubMed1985

Pneumatosis cystoides intestinalis simulating malignant colonic obstruction.

Pneumatosis cystoides intestinalis is an uncommon condition in which pockets of gas occur intramurally in the gastrointestinal tract. The authors describe the case of a 76-year-old man in whom this condition caused low colonic obstruction, simulating a rectal carcinoma. The patient was successfully treated with high-flow oxygen therapy. This form of therapy has not previously been reported in obstructing lesions, but in this case it successfully relieved the obstruction and thus avoided a colostomy that might have been necessary.

Aged↗

PubMed1991

[Pneumatosis cystoides intestinalis. Apropos of a case].

Pneumatosis cystoides intestinalis is most frequently characterised by the presence of gaseous cysts, in the intra-parietal, subserous or sub-mucous zones of the colon. This complaint, with symptoms of non specific colic and the cause of chronic pain, generally progresses favourably but can be responsible for surgical complications. Characteristic signs are detected on an plain abdominal X-ray and by colonoscopy. The diagnosis can be established by CT or by ultrasonography but needs carefully trained operators. CT remains the most successful technique for the initial diagnosis and subsequent follow-up. Ultrasonography can also be used for follow-up. As the lesions regress rapidly, the diagnosis must established rapidly, otherwise the disorder might easily be incorrectly diagnosed.

Female↗

PubMed1990

[Trichloroethylene concentration in the work environment in relation to the development of pneumatosis cystoides intestinalis].

Four cases of primary pneumatosis cystoides intestinalis (PCI) were studied in relation to occupational trichloroethylene (TRI) exposure. Three of the patients were exposed to TRI in the process of washing or polishing of camera lenses. The maximum concentration of TRI in the work environment of two PCI patients often exceeded 50 ppm, though the geometric mean concentrations were below this value. Monitoring of TRI exposure by measuring urinary TRI metabolites suggested that the third patient had been working in the environment with an 8-h time weighted average TRI concentration exceeding 50 ppm. Scrutiny of 19 PCI cases thus far collected by us revealed that i) three groups of patients (7 in total) were working in the same factories, ii) most of the PCI patients were workers in small-scale factories having poor working conditions, and iii) occupational TRI exposure is probably responsible for the development of primary PCI.

Adult↗

PubMed1998

[Pneumatosis cystoides intestinalis].

AIR-FILLED CYSTS: Pneumatosis cystoides intestinalis (PCI) is a benign air-filled cystic formation lying in submucosal or subserous digestive tissue. PCI has been reported all along the digestive tract. CLINICAL SIGNS: Manifestations of PCI vary greatly. Some cases are asymptomatic, while others are revealed by abdominal pain or pneumoperitoneum. Outcome is usually favorable. EXPLORATION: The plain radiogram of the abdomen shows gaseous cysts of various forms lying between the liver and the diaphragm. Pneumoperitoneum may be present. Computed tomography is the ideal diagnostic test. Endoscopy may be useful for colonic localizations. PATHOGENESIS: Many causes have been suggested and debated. Fifteen percent of all cases of PCI are idiopathic. In the other cases, digestive tract or respiratory tract diseases, are usually the underlying cause. Exceptionally systemic disease may be associated with PCI, particularly systemic sclerosis. TREATMENT: Surgery should be reserved for particularly severe cases.

Adolescent↗

PubMed1987

Pneumatosis cystoides intestinalis in quadriplegia: a case report.

Pneumatosis cystoides intestinalis is an uncommon clinical entity with nonspecific symptomatology of the gastrointestinal system. Its diagnosis is made by radiologic demonstration of multiple gas-filled cysts in the submucosa or subserosa of the intestinal tract. There are two major clinical types--idiopathic and secondary. A case report of a spinal cord injured patient with this condition is presented. Since gastrointestinal disturbances are common in spinal cord injured patients, health care professionals should be aware of this condition. Identification of pneumatosis cystoides intestinalis is important since it represents a benign condition and usually requires no treatment.

Humans↗

PubMedDate not supplied

Pneumatosis cystoides intestinalis: CT findings.

Two patients with primary pneumatosis cystoides intestinalis are presented. In both cases, the sigmoid colon was involved and there were no major complications. On computed tomography (CT), at lung window settings, the gas cysts in the colonic wall were clearly delineated. CT was useful in confirming the intramural gas cysts in patients with primary pneumatosis cystoides intestinalis.

Colon, Sigmoid↗

PubMed2005

Pneumatosis cystoides intestinalis in a rabbit doe (Oryctolagus cuniculus).

Pneumatosis cystoides intestinalis (PCI) is an infrequent condition of animals characterized by the existence of numerous thin-walled, gas-filled cystic structures within the intestinal wall and adjacent lymph nodes. Microscopically, the cystic structures appear to be dilated lymphatics located in the lamina propria, submucosa, muscularis, subserosa, mesentery, and mesenteric lymph nodes. This report describes a case of pneumatosis cystoides intestinalis in a rabbit doe from an organic farm where 20 rabbit does were fed ad libitum with a natural diet consisting of whole barley, pea beans, alfalfa hay, and a pelleted vitamin-mineral blend. A combination of nutritional, bacterial, and other factors are hypothesized as possible predisposing factors in the development of PCI.

Animals↗

PubMed1985

Pneumatosis cystoides intestinalis in Crohn's disease. Report of two cases.

Two cases of pneumatosis cystoides intestinalis in patients with Crohn's disease are reported. These cases illustrate both benign and fulminant forms of pneumatosis cystoides intestinalis, and highlight the diagnostic and therapeutic dilemma of patients in whom pneumatosis cystoides intestinalis and Crohn's disease coexist. While therapy is seldom indicated in benign forms of pneumatosis cystoides intestinalis, mortality rates with fulminant pneumatosis cystoides intestinalis are high, regardless of the type of therapy.

Adult↗

PubMed1977

The clinical significance of pneumatosis cystoides intestinalis: a report of 5 cases.

Pneumatosis cystoides intestinalis is an uncommon condition characterized by the presence of gas within the wall of the bowel. In most cases the clinical course is benign and may well be self-limiting, while in others the appearance of pneumatosis may indicate the presence of bowel ischaemia and necessitate emergency laparotomy. This paper describes 5 cases which demonstrate some of the difficulties in diagnosis and management and the improvement which can result from clinical awareness of the condition.

Adult↗

PubMed1997

[Pneumatosis cystoides intestinalis. Diagnostic elements and therapeutic approach].

Pneumatosis cystoides intestinalis is an uncommon condition characterised by multiple gas-filled cysts within the small intestine or colonic wall. Clinical manifestations are unspecific and often found in many other abdominal diseases. To avoid unnecessary laparotomy, radiologic and endoscopic findings are essential to be known. The present case associates symptoms highly suspect of neoplasia like weight loss, rectal mass, bloody stools and tenesmus. Treatment of choice is medical. In the absence of an acute abdomen, surgery is only reserved when it is not responsive to medical treatment.

Aged↗

PubMed1979

Pneumatosis cystoides intestinalis in Iran.

Nineteen cases of pneumatosis cystoides intestinalis all affecting adults and all involving the small intestine have been collected in two centres of Iran (Shiraz and Tehran) over a 20 year period, the pathological findings being divided into three groups: pure submucosal, combined submucosal and subserosal, and pure subserosal cysts. Experimental PCI was produced in cadavers using high pressure oxygen insuflation of the lungs, thus lending support to the theory that it has a mechanical origin. Other theories of aetiology include tumour, nutritional deficiencies, gas-forming organisms, alveolar rupture, and acid-base disturbance. In most of the cases presented high intraluminal pressure produced by obstruction appeared to force intraluminal gas through a breach in the mucosa into either the lymphatics or perivascular tissue to produce PCI. It is concluded that the aetiology in the vast majority of adult cases is mechanical in nature and that bacteria seem to play very little part, unlike their role in the PCI of infants.

Adult↗

PubMed1981

Pneumatosis cystoides intestinalis: a complication of systemic chemotherapy.

A case of pneumatosis cystoides intestinalis following administration of chemotherapy for Hodgkin's disease is presented. Because of a poor response to nonoperative management, a subtotal colectomy was performed. Although the pathogenesis of pneumatosis cystoides intestinalis is not entirely clear, it seems likely that, in this case, mucosal ulceration secondary to methyl-gag allowed intraluminal air to dissect into the intestinal wall and surrounding retroperitoneal tissues. Because pneumatosis cystoides intestinalis is often reversible and self-limited, fecal diversion in lieu of bowel resection is entertained as a possible alternative in the operative management of selected cases. In the case presented resection was performed because of extent of the pathologic process.

Adult↗