Pneumatosis Intestinalis — A Pitfall for Surgeons?

Pneumatosis (cystoides) intestinalis is defined as the presence of gas in the bowel wall and can be found anywhere in the gastrointestinal tract. It may be harmless or life-threatening, depending on the etiology which includes infectious and drug-induced colitis, bowel ischemia and necrotizing enterocolitis. The lesion has additionally been described following endoscopy. We report two cases of asymptomatic pneumatosis coli mimicking polyposis syndrome or malignancy. Both cases were verified histologically after snare polypectomy or hemicolectomy. The differential diagnosis and the clinical significance of the disease are discussed. Accurate diagnosis, which is mainly based upon endoscopy, computed tomography and histology, is crucial for optimal patient management thus avoiding unnecessary surgical procedures.

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“…Surgical resection, however, may be the treatment of choice in case of life-threatening underlying disease, such as acute bowel ischemia [13].…”

Section: Discussionmentioning

confidence: 99%

Pneumatosis coli – an underrecognized lesion mimicking neoplastic disease

Amrein

Högenauer

Spreizer

et al. 2011

Wien Klin Wochenschr

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“…Most patients are managed conservatively (3,22). Obviation of the need for surgical intervention and feasibility of conservative treatment were reported in the patients with benign pneumoperitoneum secondary to rupture of the subserosal gas bubbles (11,12).…”

Section: Discussionmentioning

confidence: 99%

Pneumatosis Cystoides Intestinalis: Clinical Experience in a Single Center

et al. 2012

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“…If submucosal, they are often multiple, from a few millimetres to several centimetres in diameter and form isolated or clustered sessile polyps, predominantly localised on the antimesenteric side of the lumen [30]. The bowel wall thus has a honeycombed appearance on the section.…”

Section: Pathologymentioning

confidence: 99%

Pneumatosis cystoides intestinalis

et al. 2011

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La pneumatose kystique est un état gastro-intestinal rare caractérisé par la présence de gaz dans la paroi intestinale, principalement dans celle de l'intestin grêle ou du côlon. Ce phénomène apparaît sous trois formes différentes : 1) la pneumatose kystique primaire ; 2) la forme secondaire qui accompagne un grand nombre de maladies gastrointestinales et systémiques ; 3) la pneumatose compliquant l'ischémie intestinale. La pathogénie n'est pas clairement connue, elle est très probablement multifactorielle ; la surproduction d'hydrogène est la théorie la plus probable expliquant la formation de la PKI. La Pneumatose kystique intestinale (PKI) est fréquemment découverte de manière fortuite au cours d'une coloscopie -la suspicion endoscopique de la PKI, basée sur un collapse au cours de la ponction, peut être soutenue par des prélèvements cytologiques typiques. La tomodensitométrie est la technique de radiodiagnostic la plus sensible qui peut également détecter une maladie sous-jacente. L'oxygénothérapie et les antibiotiques sont essentiels dans la prise en charge conservatrice et doivent être accompagnés d'une thérapie de la maladie sous-jacente. Les candidats à une intervention chirurgicale ou radiointerventionnelle se recrutent principalement dans la troisième forme de PKI, au cours des ischémies mésentériques aiguës. To cite this journal: Acta Endosc. 41 (2011). Mots clés Pneumatose kystique intestinale · Pneumopéritoine · Hydrogène · Ischémie intestinaleAbstract Pneumatosis cystoides is a rare gastrointestinal condition characterised by the presence of gas in the wall of the gastrointestinal tract, predominantly the small and large intestine. This phenomenon occurs in three forms: 1) primary pneumatosis cystoides, 2) a secondary form, which accompanies a wide range of gastrointestinal and systemic diseases, and 3) pneumatosis complicating intestinal ischaemia. The pathogenesis is not clearly known and is most likely multifactorial; hydrogen overproduction represents what is probably the most consistent theory of PCI formation. PCI is often an incidental finding during colonoscopy -endoscopic suspicion on PCI based on collapse during the puncture can be supported by the typical cytological findings. Computerised tomography is the most sensitive radiodiagnostic method, which can also detect possible underlying disease. Oxygen inhalation and antibiotics is the mainstay in conservative therapy, together with therapy of the underlying disease. Candidates for surgical and/or radiological intervention are mainly recruited from the third group of PCI accompanying abdominal catastrophe such as intestinal ischaemia. Pour citer cette revue : Acta Endosc. 41 (2011).

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Pneumatosis Intestinalis — A Pitfall for Surgeons?

Cited by 52 publications

References 19 publications

Pneumatosis coli – an underrecognized lesion mimicking neoplastic disease

Pneumatosis coli – an underrecognized lesion mimicking neoplastic disease

Pneumatosis Cystoides Intestinalis: Clinical Experience in a Single Center

Pneumatosis cystoides intestinalis

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