Pneumatosis Cystoides Intestinalis Induced by the Alpha-glucosidase Inhibitor Miglitol

Kojima, K; Tsujimoto, Tatsuhiro; Fujii, Hisao; Morimoto, Tadatsugu; Yoshioka, Seisaku; Kato, Saki; Yasuhara, Yumi; Aizawa, Shigeyuki; Sawai, Mizuho; Makutani, Shiro; Yamamoto, Kōji; Mochi, Tadao; Fukui, Hiroshi

doi:10.2169/internalmedicine.49.3634

Cited by 54 publications

(22 citation statements)

References 16 publications

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“…Bacterial overgrowth and bowel distension are observed in this condition, which can lead to elevated intraluminal pressure and force gas into the intestinal walls (6,19). Bacterial infection has also been proposed to either damage the intestinal wall with subsequent intramural penetration of gas or produce gas, which then penetrates into the gut wall (15). …”

Section: Discussionmentioning

confidence: 99%

“…Bacterial overgrowth and increased intraluminal production of hydrogen may cause a breakdown in mucosal integrity and gas leakage into the bowel wall and peritoneal cavity (18). Several drugs, particularly α-GI, have been reported to induce PCI development (13-15). Use of α-GI causes flatulence, because absorption of carbohydrates by the colon is suppressed, and intestinal bacteria then generate a large volume of gas through carbohydrate fermentation.…”

Section: Discussionmentioning

confidence: 99%

“…Connective tissue disease (CTD) represents an important background factor for secondary PCI (1-12). Furthermore, drugs such as α-glucosidase inhibitors (α-GI) (13-15) and immunosuppressants (16) have been reported to drive the pathophysiology of PCI. However, the pathogenetic mechanisms underlying PCI have not been elucidated, although several hypotheses have been proposed.…”

Section: Introductionmentioning

confidence: 99%

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Four Cases of Pneumatosis Cystoides Intestinalis Complicated by Connective Tissue Diseases

et al. 2017

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Pneumatosis cystoides intestinalis (PCI) is a rare disease that involves the presence of gas in the intestinal wall. Connective tissue disease (CTD) is a major cause of secondary PCI. In addition to the nature of CTDs, the use of prednisolone and some immunosuppressants, and the presence of complicating diseases such as diabetes mellitus, constipation and pulmonary diseases are involved in the development of PCI. This report describes four cases of PCI with different CTDs (granulomatosis with polyangiitis, rheumatoid arthritis, dermatomyositis, and overlap syndrome) and discusses the background of each patient and common risk factors for the occurrence of PCI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Four Cases of Pneumatosis Cystoides Intestinalis Complicated by Connective Tissue Diseases

et al. 2017

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“…In fact, prescriptions of these drugs in Japan account for 98% of total sales of voglibose and 34% of those for acarbose (3). Providing conservative treatment after discontinuing the alpha-glucosidase inhibitor generally leads to the complete resolution of PI within 28 days (16).…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Benign Pneumatosis Intestinalis with Portal Venous Gas and Pneumoperitoneum Induced by Acarbose

2015

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Alpha glucosidase inhibitors have been shown to be associated with pneumatosis intestinalis (PI) in recent reports. We herein report the case of a 73-year old man who received treatment with an alpha glucosidase inhibitor (acarbose) and presented with acute abdomen. A computed tomography scan demonstrated PI in addition to intrahepatic portal air and pneumoperitoneum. During exploratory laparotomy, we found no evidence of hollow organ perforation or bowel necrosis. The patient recovered after conservative treatment with cessation of the alpha glucosidase inhibitor. This is the first report to describe the combination of PI with portal venous gas and pneumoperitoneum caused by an alpha-glucosidase inhibitor.

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“…It has been reported that PCI in diabetic patients is highly associated with the use of α-glucosidase inhibitors as well as other secondary causes [18]. Kojima et al suggested that carbohydrates are fermented by normal intestinal flora after their intestinal absorption has been inhibited by α -glucosidase inhibitors [18].…”

Section: Discussionmentioning

confidence: 99%

A Case of Pneumatosis Cystoides Intestinalis and Portal Venous Gas Accompanied by Emphysematous Pyelonephritis in Type 2 Diabetes Mellitus

Eom

Lee

et al. 2014

J Korean Diabetes

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Diabetes mellitus is a major risk factor for urinary tract infection (UTI); emphysematous pyelonephritis (EP), a complication of UTIs, often occurs in patients with underlying, poorly controlled diabetes mellitus. We report the case of an 87-year-old woman with EP in type 2 diabetes mellitus who developed pneumatosis cystoides intestinalis (PCI) with portal venous gas. PCI is a radiographic finding, which is found in a linear or cystic form of gas in the submucosa or subserosa of the bowel wall. PCI has two common presentations. Primary PCI is a benign idiopathic condition. Secondary PCI is associated with a wide variety of gastrointestinal and nongastrointestinal diseases. PCI with portal venous gas in particular is associated with ischemic gastrointestinal disease. Initial pre-enhanced abdominopelvic computed tomography showed EP in the right kidney without PCI. Newly occurring PCI and hepatic portal venous gas were found in the right ascending colon after EP improved. This is a rare case of PCI accompanied by emphysematous pyelonephritis in type 2 diabetes mellitus. The patient's general condition improved with intravenous antibiotics and fluid therapy without a surgical approach. However, she was discharged without further treatment because the family refused any further evaluations and treatments. (

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Pneumatosis Cystoides Intestinalis Induced by the Alpha-glucosidase Inhibitor Miglitol

Cited by 54 publications

References 16 publications

Four Cases of Pneumatosis Cystoides Intestinalis Complicated by Connective Tissue Diseases

Four Cases of Pneumatosis Cystoides Intestinalis Complicated by Connective Tissue Diseases

A Rare Case of Benign Pneumatosis Intestinalis with Portal Venous Gas and Pneumoperitoneum Induced by Acarbose

A Case of Pneumatosis Cystoides Intestinalis and Portal Venous Gas Accompanied by Emphysematous Pyelonephritis in Type 2 Diabetes Mellitus

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