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[Pneumatosis cystoides intestinalis]

S U Christl1, W Scheppach, H Kasper

  • 1Medizinische Universitätsklinik, Würzburg.

Deutsche Medizinische Wochenschrift (1946)
|February 16, 1996
PubMed
Summary

Pneumatosis cystoides intestinalis, a rare condition causing severe flatulence, can be managed with a low-carbohydrate diet. This dietary approach effectively controls symptoms, though intestinal findings persist.

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Area of Science:

  • Gastroenterology
  • Medical Diagnostics

Background:

  • Presents a case study of a 56-year-old male with a 10-month history of meteorism and severe flatulence.
  • Highlights the diagnostic challenges of unexplained gastrointestinal symptoms.

Observation:

  • Abdominal distension with active, low-pitched peristalsis noted on physical examination.
  • Radiographic imaging revealed multiple round translucencies in the left hemicolon.
  • Colonoscopy identified firm-walled cysts containing high concentrations of hydrogen (H2) in the descending and sigmoid colon.

Findings:

  • Histological examination showed submucosal inflammatory infiltration and slit-like spaces, indicative of pneumatosis cystoides intestinalis.
  • Elevated H2 concentrations were confirmed via H2 breath testing, both fasting and post-lactulose.
  • Diagnosis confirmed as pneumatosis cystoides intestinalis based on clinical, endoscopic, histological, and breath test findings.

Implications:

  • Pneumatosis cystoides intestinalis should be considered in the differential diagnosis for patients presenting with meteorism and flatulence.
  • Dietary modification, specifically reducing flatulence-producing carbohydrates, offers effective symptom management for this rare condition.
  • While symptoms can be controlled, the underlying intestinal changes may remain unchanged long-term.

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