Pneumatosis cystoides intestinalis: case reports and review of the literature

Pneumatosis cystoides intestinalis is an uncommon condition in which submucosal or subserosal gas cysts are found in the wall of the small or large bowel. Many different causes of pneumatosis cystoides intestinalis have been proposed, including mechanical and bacterial causes. Approximately 85% of cases are thought to be secondary to coexisting disorders of the gastrointestinal tract or the respiratory system. Since 1986 we have observed 4 cases of pneumatosis cystoides intestinalis. A review of the literature is presented with emphasis on the etiology, diagnosis, differential diagnosis, and therapy of pneumatosis cystoides intestinalis. Symptoms of pneumatosis cystoides intestinalis include diarrhea, constipation, rectal bleeding, passage of mucus per rectum, vague abdominal discomfort, abdominal pain, urgency, malabsorption, weight loss, and excessive flatus. Depending on the location of the gas filled cysts the range of symptoms in each patient may vary enormously.