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Surgical aspects of pneumatosis cystoides intestinalis: two case reports

Engelbert Schröpfer1, Thomas Meyer

  • 1Department of General, Visceral, Vascular and Transplant-Surgery, Julius-Maximilians-University of Würzburg Würzburg Germany. Schroepfer_e@chirurgie.uni-wuerzburg.de

Cases Journal
|November 18, 2009
PubMed

Insights

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by air-filled cysts in the gastrointestinal tract. Surgical intervention for PCI is recommended only for patients with sepsis, peritonitis, or bowel perforation.

Area of Science:

  • Gastroenterology
  • Surgical Therapy
  • Rare Diseases

Background:

  • Pneumatosis cystoides intestinalis (PCI) is a rare condition involving air-filled cysts within the gastrointestinal tract wall.
  • PCI is often secondary to an underlying medical condition.
  • This study aims to develop a surgical therapy algorithm for PCI.

Observation:

  • A 17-year-old girl with Down syndrome and leukemia-related leucopenia presented with septic conditions and PCI.
  • A 79-year-old man with urothelial and prostate carcinoma presented with abdominal distension, PCI, and adhesive strangulation.

Findings:

  • The pediatric patient underwent exploratory laparotomy and right colon resection due to acute ischemia.
  • The adult patient was treated conservatively for PCI after adhesiolysis for intestinal strangulation.

Implications:

  • Exploratory laparotomy for PCI should be reserved for patients exhibiting elevated inflammatory markers, sepsis, peritonitis, or bowel perforation.
  • Conservative management may be appropriate for select PCI cases without severe complications.
Abstract

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