Recurrent intussusception associated with pneumatosis cystoides coli: A pediatric case report

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Radiology
• Surgical Pediatrics

Background:

• Pneumatosis cystoides coli (PCC) is a rare condition characterized by gas-filled cysts in the gastrointestinal tract wall.
• PCC is uncommon in pediatric populations and can present with various gastrointestinal symptoms.
• Recurrent intussusception in children can be a challenging diagnostic and therapeutic problem, sometimes requiring identification of a lead point.

Purpose of the Study:

• To report a rare case of pediatric Pneumatosis cystoides coli (PCC) presenting as recurrent ileocolic intussusception.
• To highlight the diagnostic challenges and treatment outcomes for PCC in a pediatric patient.
• To evaluate the efficacy of hyperbaric oxygen therapy in resolving PCC and associated intussusception.

Main Methods:

• Case report of a 7-year-old female with recurrent intussusception.
• Diagnostic imaging including computed tomography (CT) of the abdomen and pelvis to identify colonic mural air-filled cystic lesions.
• Treatment modalities included metronidazole, a sorbitol-free diet, continuous low-flow oxygen, and subsequently, hyperbaric oxygen therapy.

Main Results:

• The patient presented with recurrent ileocolic intussusception secondary to extensive colonic Pneumatosis cystoides coli (PCC).
• Initial treatments with antibiotics, dietary modifications, and oxygen failed to resolve the PCC.
• Hyperbaric oxygen treatment led to complete resolution of PCC and cessation of intussusception episodes.

Conclusions:

• Pneumatosis cystoides coli can be an unusual lead point for recurrent intussusception in children.
• Standard medical therapies may not be sufficient for treating PCC in pediatric patients.
• Hyperbaric oxygen therapy represents a promising and effective treatment for refractory Pneumatosis cystoides coli, resolving associated intussusception.