Rationale: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas-filled cysts in the intestinal wall, and can be caused by many conditions. Patient concerns: We reported a-69-year-old man with a long history of chronic obstructive pulmonary disease was admitted to the gastroenterology department because of alternating bowel movement and intermittent bloody stool. Diagnoses: Colonoscopy revealed multiple nodular protuberances covered with normal-looking mucosa in the ascending and proximal transverse colon. Abdominal computed tomography scan and endoscopic ultrasound revealed multiple gas-filled cystic lesions in the submucosa. The diagnosis of PCI was confirmed by cyst collapse after puncturing with a fine needle. Interventions and outcomes: Considering that the patient had no peritonitis or other complications, conservative approaches, including oxygen inhalation and oral probiotics, were used. The patient was transferred to the anorectal department after 5days of clinical observation in good condition to further treat hemorrhoids. Lessons: PCI is a rare condition that may be secondary to many other diseases. Because of its atypical clinical manifestations, it can be misdiagnosed as other diseases, such as polyps, inflammatory bowel disease, and even cancer. The diagnosis of PCI depends on computed tomography, colonoscopy, and endoscopic ultrasonography. Fine-needle aspiration may be helpful in the diagnosis and treatment of PCI.

Background Ciprofol and propofol are equally safe and effective in enabling patients to undergo painless gastroscopy. However, the effects of ciprofol on swallowing have not been reported. We aimed to compare the effects of ciprofol and propofol on pharyngeal swallowing function in patients undergoing gastrointestinal endoscopy. Methods We randomly divided 237 patients aged 22–64 years with American Society of Anesthesiologists class I–II undergoing gastrointestinal endoscopy into the ciprofol (Group C, n = 116) or propofol (Group P, n = 121) group. Patients in Group C and Group P received an intravenous bolus injection of 0.6 mg/kg ciprofol and 2.5 mg/kg propofol, respectively, with the injection time exceeding 30 s. Endoscopy was performed when the Modified Observer's Assessment of Alertness/Sedation score was ≤ 1. The primary outcome was the incidence of severe dysphagia. The Penetration and Aspiration Scale score, Dysphagia Severity Score, occurrence of laryngeal adductor reflex, and arytenoid joint laxity were recorded. The secondary outcomes included the time spent in the post-anesthesia care unit, postoperative recovery time, and incidence of gag reflex, body movement, respiratory depression, hypotension, and postoperative dizziness. Results Group C had a significantly higher incidence of the laryngeal adductor reflex than Group P (54.2% vs. 34.2%, < 0.05), while the incidence of severe dysphagia in Group C was lower than that in Group P (12.9% vs. 33.1%, P < 0.05). The incidence of body movements in Group C was lower than that in Group P (15.5% vs. 31.4%, P < 0.05). Conclusions Compared with propofol, ciprofol may be more beneficial in retaining partial pharyngeal swallowing function to reduce body movements and the risk of aspiration; however, the mechanism requires further investigation. Trial registration: This trial was registered with the China Clinical Trials Centre (Registration Number: ChiCTR2100054446, registration date: 17/12/2021).