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PubMedDate not supplied

Pneumatosis cystoides intestinalis : report of two cases.

We present two cases of Pneumatosis Cystoides Intestinalis (PCI) involving the small intestine: emergency operations was mandatory. At surgery, the affected ileal segments were resected. After surgery, clinical courses were uneventful. PCI is a sign, not a disease, and therefore its significance is directly related to the patient's overall clinical status. Treatment is not indicated in asymptomatic patients, whereas immediate surgical intervention is necessary in patients with abdominal catastrophes.

Adult↗
PubMed2002

[Pneumatosis cystoides intestinalis in emergencies: clinical management and treatment. 2 case reports].

Pneumatosis Cystoides Intestinalis gives many diagnostic and therapeutic troubles especially when it occurs in patient admitted in an emergency setting. The Authors report two cases of PCI related to patients admitted into the Emergency Department (DEA II) with diagnosis of intestinal perforation, mode according to the radiological findings of free subfrenic air, but not confirmed at physical examination. The Authors discuss the role that imaging and physical examination play in evaluating this kind of patients, considering the etiopathogenetic hypothesis about this rare disorder.

Aged↗
PubMed1988

Pneumatosis cystoides intestinalis in young patients. Case report.

A 19-year-old student with non-symptomatic pneumatosis cystoides intestinalis in the right colon is presented. He had no history of any pulmonary or other disease. According to a review of the literature there is no rational for any treatment or specific follow-up in patients with a non-symptomatic pneumatosis cystoides intestinalis.

Adult↗
PubMed1995

Pneumatosis cystoides intestinalis after chemotherapy for hematological malignancies: report of 4 cases.

Pneumatosis cystoides intestinalis (PCI) is known to be a relatively rare condition which is characterized by gas cysts in the gastrointestinal mucosa. We treated four cases of PCI accompanied by hematological malignancies during chemotherapy treatment. All cases suffered from abdominal discomfort. Abdominal X-ray films revealed gas cysts in the intestine. PCI was observed during leukocytopenic states, and three cases had septicemia. Etoposide was administered to three cases, and prednisolone to all cases. It is considered that PCI sometimes occurs in patients with hematological malignancies during a period of leukocytopenia, and may be caused by intestinal mucosal damage due to myelosuppressive agents and immunosuppression from prednisolone.

Adult↗
PubMed1985

The mucosal changes and pathogenesis of pneumatosis cystoides intestinalis.

The clinical and pathologic findings in 11 patients with pneumatosis cystoides intestinalis (PCI) are described. Symptoms were variable but localized to the gastrointestinal tract. Only one patient had obstructive airway disease. Although gas cysts of varying sizes were present in the colonic wall in all cases, distinctive changes were also observed in the mucosa. Architectural disturbances were seen in 11 of 13 specimens, and changes mimicking those of inflammatory bowel disease, including cryptitis, crypt abscesses, chronic inflammation, and granulomas, were present. In addition, crypt dilation and partial crypt rupture, with formation of intramucosal cysts, were seen in association with clusters of small gas cysts in the lamina propria. The transgression of gas cysts through the muscularis mucosae and the presence of larger giant cell-lined cysts in the submucosa suggested entry of gas generated in the colonic lumen or within inflamed crypts from the mucosal aspect. Other postulated pathogeneses of PCI are discussed.

Aged↗
PubMed1996

Pneumatosis cystoides intestinalis in AIDS-associated cryptosporidiosis. More than an incidental finding?

A 34-year-old man with acquired immunodeficiency syndrome (AIDS) developed pneumatosis cystoides intestinalis associated with an intestinal infection with Cryptosporidium organisms. The pneumatosis resolved upon treatment of the cryptosporidiosis with paromomycin and clofazimine. Four other cases of benign pneumatosis cystoides intestinalis in adults with AIDS and associated cryptosporidiosis have been reported, which suggests that cryptosporidial infection may be pathogenetically involved in the pneumatosis and not merely incidental.

AIDS-Related Opportunistic Infections↗
PubMed1986

[Negative report on trichloroethylene-induced pneumatosis cystoides intestinalis in rats].

In recent years it has been suggested in Japan that occupational trichloroethylene exposure will induce primary pneumatosis cystoides intestinalis coli. A series of two experiments were conducted to ascertain the cause-effect relationship between trichloroethylene and pneumatosis as follows: In the first experiment, 12 male rats of Fischer strain were exposed to trichloroethylene at a nearly lethal concentration for 12 wk. Five out of 12 rats died during the experiment, and body weight gain was extremely depressed. However, neither pneumatosis nor histological changes were observed. No changes were observed in 4 control rats as well. In the second experiment, 38 male rats of Sprague-Dawley strain were exposed to 800, 200 or 50 ppm trichloroethylene over a period of 12 wk. Two out of 13 rats of the 800 ppm group died, and body weight gain was suppressed. Mild suppression in body weight gain was also observed in the 200 ppm group. However, pneumatosis was not observed in any rats of trichloroethylene groups. No pathological changes were observed in 13 rats of the control group. The foregoing results suggest that trichloroethylene cannot induce pneumatosis cystoides intestinalis in rats of these two strains. Inasmuch as rats are not prone to develop pneumatosis, the possibility for trichloroethylene to induce this disease in man cannot be denied.

Animals↗
PubMedDate not supplied

Treatment of pneumatosis cystoides intestinalis with high FIO2: report of two cases.

We have successfully treated two patients with symptomatic pneumatosis cystoides intestinalis using a high FIO2 delivered by face mask, with administration interrupted at meal times. While we advocate oxygen therapy for this disease, caution must be taken to avoid the complications of high PaO2, namely proliferative and fibrotic lung changes. Close attention should be paid to the development of increasing cough, dyspnea and shortness of breath. As the frequency of the diagnosis of pneumatosis cystoides intestinalis increases, the success of high inspired oxygen as therapy should be recognized.

Aged↗
PubMed2000

Pneumatosis cystoides intestinalis: an unexpected finding in intestinal bleeding under therapy with phenprocoumon.

Pneumatosis cystoides intestinalis is a rarely observed disorder on plain abdominal X-ray or colonoscopy examination. Although causing few complaints in adults, it can nevertheless lead to gastrointestinal bleeding. In the reported case, gastrointestinal bleeding was observed with coinciding pneumatosis and phenprocoumon therapy. After stopping anticoagulant therapy, pneumatosis vanished completely, thus suggesting that phenprocoumon is probably a further cause of the cystic disease. In the known list of drugs able to provoke pneumatosis, this case adds a new mechanism of affliction different to either immunosuppression or gas production.

Aged↗
PubMed1977

Pneumatosis cystoides intestinalis. Report of two cases.

The histories of two patients with pneumatosis cystoides intestinalis are reported. In the first case a left hemicolectomy was performed because of suspicion of polyposis coli. The other patients was given symptomatic treatment. Conservative treatment is recommended by most authors, but since the disorder is seldom seen, unnecessary surgery is often performed because of incorrect preoperative diagnosis.

Aged↗
PubMed1986

Pneumatosis cystoides intestinalis with pneumoperitoneum in renal transplant patients on cyclosporine and prednisone.

Pneumatosis cystoides intestinalis has been detected in 3/103 kidney transplant patients (3%) treated with CsA and prednisone, in contrast to less than 1% of kidney transplant patients treated with Aza and prednisone. In these three patients, the diagnosis of PCI was made by plain x-rays, 10 to 25 days after transplantation. PCI may be more likely to occur in patients with CsA trough blood levels above the recommended therapeutic range. There was associated pneumoperitoneum in all three patients, but none were subjected to exploratory laparotomy. PCI and associated pneumoperitoneum were not associated with adverse effects in any of our three patients. Antibiotics and exploratory laparotomy appear to be unnecessary.

Adolescent↗
PubMed2006

Pneumatosis cystoides intestinalis with systemic sclerosis, limited type resulting in a poor prognosis.

Pneumatosis cystoides intestinalis (PCI) is a rare disease characterized by the presence of multilocular intramural clusters of gas in the alimentary tract and has been considered to have a favorable response to conservative treatment. We describe the first case of limited type of systemic sclerosis (SSc) with PCI. A 74-year-old Japanese woman presented with a 4-month history of an unhealed cutaneous ulcer on the right third finger, along with sclerodactyly of bilateral hands. Proximal skin sclerosis was absent. The patient reported acute abdominal pain, and a diagnosis of PCI was established on plain radiography. The patient died of multiple organ failure 5 months after the development of PCI. PCI is rarely complicated with SSc, and all cases previously reported were associated with diffuse SSc. Because PCI is one of the poor prognostic factors of SSc, we should recognize the presence of this condition even in patients with limited cutaneous involvement.

Aged↗
PubMed1998

[Pneumatosis cystoides intestinalis associated with intravenous pulse cyclophosphamide treatment for systemic lupus erythematosus].

Pneumatosis cystoides intestinalis (PCI) is an uncommon disease manifestation characterized by the presence of air in the bowel wall. PCI is sometimes observed in patients with progressive systemic sclerosis or mixed connective tissue disease but extremely rare in patients with systemic lupus erythematosus (SLE). We here report a patient with SLE who developed PCI after the treatment with intravenous cyclophosphamide (IVCY). This is the first case that association between IVCY and PCI was suggested. A 51-year-old woman with a 24-year history of SLE was admitted to our hospital because of skin ulcers in the lower legs. She had been receiving prednisolone orally. Laboratory findings on the present admission showed a elevated titer of anti-double stranded DNA antibody and positive LE test. She was successfully treated with three pulses of methylprednisolone followed by two IVCY together with vasodilators for her disease activity of SLE including skin manifestation. Just after the second IVCY, abdominal distention was gradually developed without any other abdominal symptoms, including abdominal pain. Abdominal radiography and computed tomography revealed pneumoperitoneum and multiple intramural air collections which involved the ascending colon primarily. Gastrointestinal series, however, showed no evidence of intestinal perforation. The diagnosis of PCI was made radiologically. After she was treated with a combined therapy with intravenous hyperalimentation and breathing with high concentration of oxygen for three weeks, PCI and pneumoperitoneum disappeared. It would be necessary that IVCY is carefully administrated, especially for the patients under the risk of PCI, such as collagen diseases.

Cyclophosphamide↗
PubMed1979

Pneumatosis cystoides intestinalis. Report of two cases involving the descending colon.

Two cases of pneumatosis cystoides intestinalis of the descending colon are described in which the presenting symptoms were abdominal pain and changed bowel habits, respectively. The diagnosis in both cases was established radiologically and sigmoidoscopically. Because the symptoms were persistent and severe, surgical excision of the involved segment of the large bowel was performed. The postoperative result was good and both patients remain free of symptoms.

Colonic Diseases↗
PubMed2006

Pneumatosis cystoides intestinalis: imaging findings with colonoscopy correlation.

We report on a case of pneumatosis cystoides intestinalis in a 32-year-old woman affected by coeliac disease with stool cultures positive for salmonella. After plain film of the abdomen, patient underwent computed tomography and magnetic resonance colonography studies that demonstrated numerous, diffuse bubblelike intramural gas collections into the ascending, transverse and descending colonic wall. CT and MR findings were correlated with colonoscopy.

Adult↗
PubMed1975

Pneumatosis cystoides intestinalis. Treatment with oxygen via close-fitting mask.

Four patients with pneumatosis cystoides intestinalis were recently treated with oxygen via a close-fitting mask. They responded initially to this therapy, with cessation of all symptoms and, after seven days of treatment, with return of proctoscopic and barium-contrast roentgenographic findings in the colon to normal. However, the disease recurred in one of the four patients after six months. There is a potential hazard of toxic effects from oxygen, and this may be detected by frequent measurement of pulmonary vital capacity. Our experience corroborates the efficacy of oxygen therapy in the treatment of this disorder but we question its long-term effectiveness in all cases.

Aged↗