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Two Cases of Pneumatosis Cystoides Intestinalis With Intraperitoneal Free Air.
Kensuke Wada1, Nobuhiro Takeuchi2, Masakazu Emori2
1Department of Internal Medicine, Kawasaki Hospital, Kobe, Japan.
Pneumatosis cystoides intestinalis (PCI) with intraperitoneal free air (IFA) requires careful diagnosis. This report details two cases, highlighting the importance of distinguishing PCI from intestinal perforation for appropriate patient management.
Area of Science:
- Gastroenterology
- Abdominal Imaging
- Surgical Diagnosis
Background:
- Intraperitoneal free air (IFA) can be associated with pneumatosis cystoides intestinalis (PCI).
- Accurate differentiation between PCI and intestinal perforation is critical for effective management.
- This study presents two distinct cases of PCI co-occurring with IFA.
Observation:
- Case 1: A 70-year-old female with schizophrenia presented with vomiting and fever; CT revealed intestinal cysts and IFA. Exploratory laparotomy confirmed PCI without perforation.
- Case 2: A 79-year-old male with emphysema presented with dyspnea and abdominal distention; CT showed intestinal cysts and massive IFA. Conservative management was initiated.
Findings:
- Both cases demonstrated PCI with IFA, necessitating diagnostic evaluation to rule out perforation.
- Surgical intervention (Case 1) and conservative management (Case 2) were employed based on clinical presentation and diagnostic findings.
- The presence of IFA in PCI cases underscores the complexity of diagnosis and treatment planning.
Implications:
- Highlights the diagnostic challenges in differentiating PCI with IFA from surgical emergencies like perforation.
- Emphasizes the need for tailored management strategies based on individual patient factors and diagnostic imaging.
- Contributes to the understanding of rare presentations of PCI and its association with free intraperitoneal air.
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