[Pneumatosis Coli Treated with Metronidazole and Hyperbaric Oxygen Therapy: A Successful Case]

Area of Science:

• Gastroenterology
• Surgical Oncology

Background:

• Pneumatosis intestinalis is a rare condition characterized by gas in the bowel wall, often presenting variably and potentially linked to other underlying pathologies.
• Diagnosis typically relies on imaging, with computed tomography scans being the most sensitive modality for detecting bowel wall gas.
• Conservative management is often feasible for pneumatosis intestinalis if complications like perforation or peritonitis are absent.

Observation:

• A 59-year-old woman presented with pneumatosis coli, a specific form of pneumatosis intestinalis.
• The condition was found to be secondary to a benign ovarian teratoma.
• Despite surgical intervention for the teratoma, the patient remained symptomatic.

Findings:

• The patient's persistent symptoms necessitated further treatment beyond surgery.
• A combination therapy involving metronidazole and hyperbaric oxygen was administered.
• This treatment regimen led to successful resolution of the patient's symptoms.

Implications:

• This case underscores the importance of considering secondary causes for pneumatosis intestinalis, even in the presence of a primary tumor.
• It demonstrates the potential efficacy of a multimodal treatment approach, including antibiotics and hyperbaric oxygen therapy, for refractory cases.
• The findings suggest that metronidazole and hyperbaric oxygen therapy can be valuable therapeutic options for managing symptomatic pneumatosis coli when conservative measures and surgery are insufficient.