Pneumatosis cystoides intestinalis: a complication of systemic chemotherapy

A case of pneumatosis cystoides intestinalis following administration of chemotherapy for Hodgkin's disease is presented. Because of a poor response to nonoperative management, a subtotal colectomy was performed. Although the pathogenesis of pneumatosis cystoides intestinalis is not entirely clear, it seems likely that, in this case, mucosal ulceration secondary to methyl-gag allowed intraluminal air to dissect into the intestinal wall and surrounding retroperitoneal tissues. Because pneumatosis cystoides intestinalis is often reversible and self-limited, fecal diversion in lieu of bowel resection is entertained as a possible alternative in the operative management of selected cases. In the case presented resection was performed because of extent of the pathologic process.