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Pneumatosis cystoides intestinalis in intestinal pseudoobstruction. Resolution after therapy with metronidazole
P P Tak1, C M Van Duinen, P Bun
1Department of Gastroenterology, University Hospital Leiden, The Netherlands.
Abstract:
A 66-year-old man with chronic idiopathic intestinal pseudoobstruction was admitted for pneumatosis cystoides intestinalis, complicated by pneumoperitoneum. The latter conditions resolved after treatment with metronidazole. There was no favorable effect of the prokinetic agents cisapride and erythromycin. To the authors' knowledge, this is the first reported case of successful treatment of pneumatosis cystoides intestinalis with metronidazole in primary chronic intestinal pseudoobstruction.
Insights
Metronidazole effectively treated pneumatosis cystoides intestinalis in a patient with chronic idiopathic intestinal pseudoobstruction. This case highlights metronidazole as a potential therapeutic option for this rare gastrointestinal condition.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pharmacology
Background:
- Chronic idiopathic intestinal pseudoobstruction (CIIPO) is a rare motility disorder.
- Pneumatosis cystoides intestinalis (PCI) is a condition characterized by gas-filled cysts in the intestinal wall.
- Pneumoperitoneum, the presence of air in the abdominal cavity, can be a serious complication of PCI.
Observation:
- A 66-year-old male patient with a history of CIIPO presented with PCI complicated by pneumoperitoneum.
- The patient received treatment with metronidazole, cisapride, and erythromycin.
- Clinical improvement was observed following metronidazole administration.
Findings:
- Metronidazole treatment led to the resolution of pneumatosis cystoides intestinalis and pneumoperitoneum.
- Prokinetic agents, cisapride and erythromycin, did not demonstrate any favorable effect on the patient's condition.
- This represents the first reported instance of successful metronidazole therapy for PCI in the context of primary CIIPO.
Implications:
- Metronidazole may be a viable treatment option for pneumatosis cystoides intestinalis, particularly in patients with underlying chronic intestinal pseudoobstruction.
- Further research is warranted to explore the efficacy and safety of metronidazole in managing PCI associated with CIIPO.
- This case contributes to the limited understanding of therapeutic strategies for managing complex gastrointestinal conditions like PCI in CIIPO patients.