Combination therapy for systemic sclerosis-associated pneumatosis intestinalis.

Area of Science:

• Gastroenterology
• Rheumatology
• Radiology

Background:

• Systemic sclerosis is a multisystem autoimmune disease.
• Gastrointestinal involvement is common but pneumatosis intestinalis is a rare complication.
• Management of pneumatosis intestinalis in systemic sclerosis lacks established guidelines.

Observation:

• A patient with gastrointestinal systemic sclerosis presented with abdominal pain.
• The patient was diagnosed with pneumatosis intestinalis and pneumoperitoneum.
• Recurrent emergency attendances indicated a need for effective management.

Findings:

• Successful medical management was achieved with a combination of antimicrobial therapy, elemental diet, and high-flow oxygen.
• Computed tomography (CT) imaging confirmed the resolution of pneumatosis intestinalis and pneumoperitoneum.
• This represents the first reported case of symptomatic and radiological improvement with this combination therapy without surgical intervention.

Implications:

• This case highlights a potential non-surgical treatment strategy for pneumatosis intestinalis in systemic sclerosis.
• The findings may inform future clinical practice and research into managing this rare complication.
• Further investigation is warranted to validate this therapeutic approach in a larger cohort.