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Related Experiment Videos

[Pneumoperitoneum with systemic sclerosis].

A Nakajima1, Y Koseki, A Suwa

  • 1Division of Rheumatic Diseases, Tokyo Metropolitan Ohtsuka Hospital.

Ryumachi. [Rheumatism]
|February 27, 1999
PubMed
Summary
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Systemic sclerosis (SSc) can cause benign pneumoperitoneum without pneumatosis cystoides intestinalis (PCI). This rare complication in SSc patients requires conservative management when no peritoneal irritation is present.

Area of Science:

  • Gastroenterology
  • Rheumatology
  • Internal Medicine

Background:

  • Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by fibrosis, vascular abnormalities, and immune dysregulation.
  • Gastrointestinal manifestations are common in SSc, including dysmotility, malabsorption, and bacterial overgrowth.
  • Pneumatosis cystoides intestinalis (PCI) is a rare gastrointestinal complication of SSc.

Observation:

  • A 43-year-old woman with SSc presented with significant abdominal distension, diarrhea, constipation, and subileus.
  • Radiographic imaging revealed pneumoperitoneum and bowel dilatation but no apparent PCI.
  • The patient experienced recurrent diarrhea and fever, with Klebsiella pneumoniae identified in jejunal aspirates.

Findings:

  • The case highlights benign pneumoperitoneum as a rare complication of SSc, distinct from PCI.

Related Experiment Videos

  • Intravenous hyperalimentation led to improvement of pneumoperitoneum.
  • Treatment with prostaglandin F2 alpha and fosfomycin calcium resolved infectious complications.

    • Implications:

    • Benign pneumoperitoneum in SSc may result from intestinal wall weakness, dysmotility, bacterial overgrowth, and increased intraluminal pressure.
    • Conservative management is recommended for SSc-associated pneumoperitoneum without signs of peritonitis, given the poor outcomes of surgical intervention.
    • This case underscores the importance of considering rare gastrointestinal complications in SSc management.