Neumatosis quística intestinal como causa infrecuente de dolor abdominal crónico

La neumatosis quística intestinal es una enfermedad rara, caracterizada por la presencia de quistes aéreos en la pared del tracto gastrointestinal. Su distribución es variable y la localización extraintestinal es poco común. Caso clínico: Mujer de 62 años con dolor abdominal, náusea y vómito. A la exploración abdomen distendido, con dolor a la palpación en hemiabdomen superior, sin datos de irritación peritoneal. Se realizan radiografías de tórax y abdomen, con aire libre subdiafragmático, íleo en mesogastrio y neumobilia, la tomografía con neumatosis quística intestinal de intestino delgado y neumoperitoneo. La neumatosis quística intestinal tiene una prevalencia de 0.03%, tiene una incidencia global de 3/10,000 personas y es más frecuente en hombres que mujeres. Fue descrita por primera vez en 1730 por DuVernoy. Su diagnóstico es complejo, su evolución clínica suele ser crónica y benigna, cursando asintomática en la mayoría de los casos. Los casos con neumatosis quística intestinal representan un reto diagnóstico ante el cirujano, dada la incertidumbre entre el hallazgo imagenológico del aire libre subdiafragmático y la ausencia de datos clínicos de irritación peritoneal.

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“…Normalmente es una condición que no requiere intervención quirúrgica, esta se reserva a casos que presenten síntomas graves o complicaciones. 3…”

Section: Introductionunclassified

Neumoperitoneo secundario a neumatosis quística intestinal

Avilez¹,

Jaime²,

González³

et al. 2020

Anales Médicos De La Asociación Médica Del Centro Médico ABC

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“Cystamatic” Review: Is Surgery Mandatory for Pneumatosis Cystoides Intestinalis?

Brighi¹,

Vaccari²,

Lauro³

et al. 2019

Dig Dis Sci

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Introduction Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of intramural gas cysts within the small and large intestines. We describe a case of a 70-year-old man admitted to the Emergency Surgery Department for PCI who was treated conservatively. Areas Covered We reviewed 60 cases of PCI described in the international literature over the last 5 years. From our analysis, it appears that the etiology of the gas production within the submucosa or the subserosa of the gastrointestinal tract is still unknown. The rupture of the cysts can lead to pneumoperitoneum that can simulate a surgical emergency. Expert Commentary For patients with PCI, a conservative approach is the treatment of choice, with surgery mandatory only for complicated disease. Keywords Pneumatosis cystoides intestinalis • Conservative management • Spontaneous pneumoperitoneum Abbreviations CTComputed tomography scan PCI Pneumatosis cystoides intestinalis COPD Chronic obstructive pulmonary disease Case Report and EvolutionA 70-year-old man was admitted to the Emergency Department of St. Orsola University Hospital-Bologna-due to the onset of abdominal pain associated with rectorrhagia. His past medical history included hypertension, atrial fibrillation treated with oral anticoagulants, an episode of stroke with dysphagia and dysarthria, cerebrovascular disease, nephrectomy for renal cancer, and diabetes mellitus. In the emergency department, physical examination, blood tests, and chest X-ray were performed. Physical examination was remarkable for upper abdominal direct tenderness in the * A. Lauro

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