Surgical treatment for pneumatosis cystoides intestinalis complicating jejunoileal by-pass

A case of chronic pneumatosis cystoides intestinalis, complicating jejunoileal by-pass procedure for morbid obesity, is described. Grave clinical symptoms associated with irreversible segmental mucosal atrophy and mural fibrosis resulting from untreated long-standing pneumatosis intestinalis, required resection of the whole by-passed small intestine. It is suggested that this simple and safe surgical procedure is justified in selected cases. Conservative treatment of asymptomatic patients with pneumatosis intestinalis, however, may prevent further surgical intervention in these patients.