Endoscopic ultrasound of pneumatosis cystoides intestinalis

Castro-Poças, Fernando; Araújo, Tarcísio; Pedroto, Isabel

doi:10.1055/s-0034-1391873

Cited by 9 publications

(8 citation statements)

References 1 publication

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“…Contrast-enhanced CT has an advantage in revealing gas within the portal venous system [ 26 ]. Endoscopic ultrasonography findings of the mucosal layer low echo below the cystic in the diagnosis of PCI is superior [ 27 ], which can avoid the risk of CT examination and distinguish from other diseases, such as polyps, carcinoma, lymphoma, liquid cysts, Gardner syndrome, Cronkhite-Canada syndrome, Peutz-Jehers syndrome, Crohn’s disease, etc. [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Pneumatosis cystoides intestinalis: six case reports and a review of the literature

Wang

Zheng

et al. 2018

BMC Gastroenterol

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BackgroundPneumatosis cystoides intestinalis (PCI) is characterized by gas-filled cysts in the intestinal submucosa and subserosa. There are few reports of PCI occurring in duodenum and rectum. Here we demonstrated four different endoscopic manifestations of PCI and three cases with intestinal stricture all were successfully managed by medical conservative treatment.Case presentationThere are 6 cases of PCI with varied causes encountered, in which the etiology, endoscopic features, treatment methods and prognosis of patients were studied. One case was idiopathic, while the other one case was caused by exposing to trichloroethylene (TCE), and the remaining four cases were secondary to diabetes, emphysema, therioma and diseases of immune system. Of the six patients, all complained of abdominal distention or diarrhea, three (50%) reported muco-bloody stools, two (33.3%) complained of abdominal pain. In four other patients, PCI occurred in the colon, especially the sigmoid colon, while in the other two patients, it occurred in duodenum and rectum. Endoscopic findings were divided into bubble-like pattern, grape or beaded circular forms, linear or cobblestone gas formation and irregular forms. After combination of medicine and endoscopic treatment, the symptoms of five patients were relieved, while one patient died of malignant tumors.ConclusionPCI endoscopic manifestations were varied, and radiology combined with endoscopy can avoid misdiagnosis. The primary bubble-like pattern can be cured by endoscopic resection, while removal of etiology combined with drug therapy can resolve majority of secondary cases, thereby avoiding the adverse risks of surgery.

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Section: Discussionmentioning

confidence: 99%

Pneumatosis cystoides intestinalis: six case reports and a review of the literature

Wang

Zheng

et al. 2018

BMC Gastroenterol

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“…Some studies have indicated that endoscopic ultrasound (EUS) and endoscopic fine-needle aspiration are useful for the diagnosis and treatment of PCI. [5][6][7][8] Here, we report the case of a 69-year-old man admitted to the gastroenterology department with alternating bowel movements and intermittent bloody stool. PCI was diagnosed using abdominal computed tomography (CT) scan, colonoscopy, and EUS.…”

Section: Introductionmentioning

confidence: 99%

Pneumatosis cystoides intestinalis

et al. 2022

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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.

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“… Although the diagnosis can be made by radiological studies [ 3 , 4 , 5 , 6 ], a colorectal EUS and colonoscopy can be made in the same section without radiation and with high precision [ 4 , 5 , 6 ]. An Endoscopic Ultrasound (EUS) ( Video S1 ) was performed for lesion evaluation.…”

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confidence: 99%

Endoscopic Ultrasound View of Pneumatosis Cystoides Intestinalis

et al. 2023

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Pneumatosis cystoid intestinalis (PCI) is a rare condition, with a worldwide incidence of 0.3–1.2%. PCI is classified into primary (idiopathic) and secondary forms, with 15% and 85% of presentations, respectively. This pathology was associated with a wide variety of underlining etiologies to explain the abnormal accumulation of gas within the submucosa (69.9%), subserosa (25.5%), or both layers (4.6%). Many patients endure misdiagnosis, mistreatment, or even inadequate surgical exploration. In this case, a patient presented acute diverticulitis, after treatment, a control colonoscopy was performed that found multiple rounds and elevated lesions. To further study the subepithelial lesion (SEL), a colorectal endoscopic ultrasound (EUS) was performed with an overtube in the same procedure. For safe insertion of the curvilinear array EUS, an overtube with colonoscopy was positioned through the sigmoid as described by Cheng et al. The EUS evaluation evidenced air reverberation in the submucosal layer. The pathological analysis was consistent with PCI’s diagnosis. The diagnosis of PCI is usually made by colonoscopy (51.9%), surgery (40.6%), and radiological findings (10.9%). Although the diagnosis can be made by radiological studies, a colorectal EUS and colonoscopy can be made in the same section without radiation and with high precision. As it is a rare disease, there are not enough studies to define the best approach, although colorectal EUS should be preferred for a reliable diagnosis.

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Endoscopic ultrasound of pneumatosis cystoides intestinalis

Cited by 9 publications

References 1 publication

Pneumatosis cystoides intestinalis: six case reports and a review of the literature

Pneumatosis cystoides intestinalis: six case reports and a review of the literature

Pneumatosis cystoides intestinalis

Endoscopic Ultrasound View of Pneumatosis Cystoides Intestinalis

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