[Pneumatosis cystoides intestinalis complicated with intestinal volvulus]. / Neumatosis quística intestinal complicada con vólvulo intestinal.

Pneumatosis cystoides intestinalis is a rare condition in which multiple gas-filled cysts are found within the wall of the gastrointestinal tract either in the subserosa or submucosa. Its pathogenesis is uncertain and several pathogenic mechanisms have been proposed to explain its origin. The case of a male patient of 46 years with previous diagnosis of pneumatosis cystic intestinalis, who consulted for abdominal pain, vomiting and fever (39 °C) is presented. By the time of admission ther were signs of peritoneal irritation. The X-ray abdominal reported distension and intestinal hydro-air levels. Exploratory laparotomy was performed and revealed small bowel volvulus with strangulation of some intestinal segment. Histological diagnosis was pneumatosis cystic intestinalis complicated with Infarction trans-mural by intestinal volvulus. The patient evolved satisfactorily.

Neumatosis quística intestinal complicada con vólvulo intestinal / Pneumatosis cystoides intestinalis complicated with intestinal volvulus

La neumatosis quística intestinal es una condición infrecuente caracterizada por la presencia de quistes con gas en la subserosa o submucosa del tracto gastrointestinal. Su patogénesis es incierta y se han propuesto varios mecanismos patogénicos para explicar su origen. Se presenta el caso de un paciente de sexo masculino de 46 años de edad con diagnóstico previo de neumatosis quística intestinal, que consultó por dolor abdominal, vómitos y fiebre (39 °C). Ingreso con signos de irritación peritoneal. La radiografía simple de abdomen reportó distensión intestinal y niveles hidroaéreos. Se realizó laparotomía exploratoria que reveló vólvulo de intestino delgado con estrangulamiento de algunas asas intestinales. El diagnóstico anatomopatológico fue neumatosis quística intestinal complicada con Infarto transmural por vólvulo intestinal. El paciente evoluciono satisfactoriamente

Pneumatosis cystoides intestinalis is a rare condition in which multiple gas-filled cysts are found within the wall of the gastrointestinal tract either in the subserosa or submucosa. Its pathogenesis is uncertain and several pathogenic mechanisms have been proposed to explain its origin. The case of a male patient of 46 years with previous diagnosis of pneumatosis cystic intestinalis, who consulted for abdominal pain, vomiting and fever (39 °C) is presented. By the time of admission ther were signs of peritoneal irritation. The X-ray abdominal reported distension and intestinal hydro-air levels. Exploratory laparotomy was performed and revealed small bowel volvulus with strangulation of some intestinal segment. Histological diagnosis was pneumatosis cystic intestinalis complicated with Infarction trans-mural by intestinal volvulus. The patient evolved satisfactorily.

Neumatosis intestinal.

The intestinal pneumatosis is a clinical entity that is described as the presence of gas within the intestinal wall and portomesenteric venous complex as an air cysts without surrounded or no epithelial lining by a granulomatous infiltrate with giant cells multinucleic.1 It is a extremely rare clinical entity that has been characteristically associated with intestinal ischemia and high mortality. We present two cases of intestinal pneumatosis tomographic reports, admitted with clinical symptoms of intestinal obstruction. Recent advances in imaging techniques, mainly in multislice computed tomography (MSCT), allow a reliable and accurate early diagnosis of these findings.

[Pneumatosis cystoides intestinalis: a case report and review of the literature]. / Pneumatosis quística intestinalis: presentación de un caso y revisión de la literatura.

Pneumatosis cystoides intestinalis features the presence of subserum or submucous cysts with gas in the intestinal wall. Its prevalence is 0.03%, although it has increased in the past decades due to a greater use of colonoscopy in everyday medical practice. Though there are several theories about its origin and many associated diseases were reported, its pathogenesis still remains uncertain. It is generally diagnosed as a finding in an imaging test. The treatment depends on the severity of the associated disease and symptoms. We report the case of a 59-year-old woman, heavy smoker, with no other clinical conditions who took a medical consultation due to abdominal bloating. She underwent a screening colonoscopy which detected the existence of cysts on the colonic wall. Afterwards, a computed tomography was performed and showed apical lung bullae, gas in a colonic wall segment, and ascitis associated to a big anexial tumor. She underwent a cytoreductive surgery, confirming the presence of advanced ovary neoplasm. The endoscopic biopsy confirmed the diagnosis of penumatosis cystoides intestinalis. We report these case because it is a rare entity which requires uncommon management and treatment guidelines.

Pneumatosis quística intestinalis: presentación de un caso y revisión de la literatura / [Pneumatosis cystoides intestinalis: a case report and review of the literature].

Pneumatosis cystoides intestinalis features the presence of subserum or submucous cysts with gas in the intestinal wall. Its prevalence is 0.03

, although it has increased in the past decades due to a greater use of colonoscopy in everyday medical practice. Though there are several theories about its origin and many associated diseases were reported, its pathogenesis still remains uncertain. It is generally diagnosed as a finding in an imaging test. The treatment depends on the severity of the associated disease and symptoms. We report the case of a 59-year-old woman, heavy smoker, with no other clinical conditions who took a medical consultation due to abdominal bloating. She underwent a screening colonoscopy which detected the existence of cysts on the colonic wall. Afterwards, a computed tomography was performed and showed apical lung bullae, gas in a colonic wall segment, and ascitis associated to a big anexial tumor. She underwent a cytoreductive surgery, confirming the presence of advanced ovary neoplasm. The endoscopic biopsy confirmed the diagnosis of penumatosis cystoides intestinalis. We report these case because it is a rare entity which requires uncommon management and treatment guidelines.

Pneumatosis quística intestinalis: presentación de un caso y revisión de la literatura. / [Pneumatosis cystoides intestinalis: a case report and review of the literature].

Pneumatosis cystoides intestinalis features the presence of subserum or submucous cysts with gas in the intestinal wall. Its prevalence is 0.03

, although it has increased in the past decades due to a greater use of colonoscopy in everyday medical practice. Though there are several theories about its origin and many associated diseases were reported, its pathogenesis still remains uncertain. It is generally diagnosed as a finding in an imaging test. The treatment depends on the severity of the associated disease and symptoms. We report the case of a 59-year-old woman, heavy smoker, with no other clinical conditions who took a medical consultation due to abdominal bloating. She underwent a screening colonoscopy which detected the existence of cysts on the colonic wall. Afterwards, a computed tomography was performed and showed apical lung bullae, gas in a colonic wall segment, and ascitis associated to a big anexial tumor. She underwent a cytoreductive surgery, confirming the presence of advanced ovary neoplasm. The endoscopic biopsy confirmed the diagnosis of penumatosis cystoides intestinalis. We report these case because it is a rare entity which requires uncommon management and treatment guidelines.

Neumatosis intestinal y gas portal, asociada a trombosis portal: comunicación de un caso y revisión de literatura / Pneumatosis intestinalis and portal hepatic gas in asociation with portal thrombosis

Se presenta un caso clínico de una asociación infrecuente de Neumatosis intestinal con gas en vena porta y trombosis portal. Mujer de 37 años quien presenta cuadro de distensión y dolor abdominal de cuadro días de evolución. A su ingreso se encuentra afebril con presión arterial de 120/70. A su examen físico destaca sólo sensibilidad abdominal. Se realiza tomografía computada de abdomen y pelvis que muestra presencia de imágenes quísticas con gas en pared de colon ascendente, aire en sistema venoso portal y trombosis en rama de la vena porta. Se inicia tratamiento con antibióticos y oxígeno.La paciente evoluciona en forma favorable siendo dada de alta 11 días después de su ingreso. Varios estudios han mostrado que la Neumatosis intestinal aislada o con gas en la vena porta puede estar asociada a diferentes condiciones clínicas, sin embargo, la asociación de Neumatosis intestinal, gas y trombosis portal es un hallazgo infrecuente.

We report a rare condition of Pneumatosis intestinalis with hepatic portal venous gas associated to portal thrombosis. A 37 years old female presented with abdominal pain andbloating from four days before admission. Blood pressure was 120/70 and body temperature normal. Physical examination revealed only abdominal tenderness. CT scan showed intestinalgas-filled cysts, air in portal venous system and thrombosis at portal vein branches. Treatment with oxygen and antibiotic therapy was followed by a clinical improvement and patient was discharged after 11 days. Several studies have reported Pneumatosis intestinalis alone and with Hepatic portal venous gas in different pathological conditions. HoweverPneumatosis intestinalis with hepatic portal venous gas associated with portal thrombosis is a unusual condition.

[Pneumatosis intestinalis. Report of 3 cases]. / Neumatosis intestinal. Informe de tres casos.

OBJECTIVE: To describe the clinical, radiological, morphological, and immunohistochemical characteristics of three cases of pneumatosis intestinalis. METHODS: From 1982 to 1999, cases diagnosed as pneumatosis cystoides intestinalis were reviewed. The laboratory results, X-ray findings, clinical course, treatment and evolution were obtained from the clinical charts. Slides and macroscopic photos were obtained from the surgical pathology files. New slides were obtained from the paraffin blocks for immunohistochemical detection of endothelial cells (CD 31) and macrophagic cells (CD 68). RESULTS: We found three patients with pneumatosis intestinalis associated to a history of abdominal surgeries from 936 enteral resections (0.3%). These three patients showed clinical features of intestinal obstruction. Morphological and immunohistochemical analysis showed pseudocysts without an epithelial and endothelial lining. Some spaces were lined by multinucleated giant cells positive for CD 68 and endothelial cells that were CD 31 positive. CONCLUSIONS: Antecedent of obstruction and abdominal surgeries were the constant association with pneumatosis cystoides intestinalis. Most lesions were pseudocysts without epithelial or endothelial lining.

Pneumatosis intestinale in children with primary combined immunodeficiency.

We report six episodes of pneumatosis intestinale (PI) in children with primary combined immunodeficiency. PI was generally benign and responded to conservative therapy. Increased risk of infection or disruption of gastrointestinal mucosa are probable predisposing factors. A diagnosis of PI should be considered in children with primary combined immunodeficiency who experience otherwise unexplained gastrointestinal symptoms, particularly in the early post-transplant period.

Neumatosis quística intestinal en síndrome de Crest

Presentamos un caso de neumatosis quística intestinal (NQI) en una paciente de 64 años con diagnóstico de Síndrome de Crest. Esta complicación simulaba un abdomen agudo por perforación de vícera hueca. Las radiografías del abdomen evidenciaron neumoperitoneo y neumatosis quística intestinal. Se le practicó laparotomía y se encontro neumatosis quística intestinal, diagnóstico confirmado con patología.