A Case of pneumatosis cystoides intestinalis with chronic idiopathic intestinal pseudoobstruction

Taku Kitayama; Tetsuyuki Uchiyama; Tomoya Abe; Tatsuya Ueno; Masaru Ohnuma; Chikashi Shibata; Hideo Ise; Mika Watanabe

doi:10.5833/jjgs.43.828

A Case of pneumatosis cystoides intestinalis with chronic idiopathic intestinal pseudoobstruction

Taku Kitayama, Tetsuyuki Uchiyama, Tomoya Abe, Tatsuya Ueno, Masaru Ohnuma, Chikashi Shibata, Hideo Ise, Mika Watanabe

Research output: Contribution to journal › Article › peer-review

Abstract

A 23-years-old man diagnosed in childhood as having chronic idiopathic intestinal pseudoobstruction (CUP) and admitted for abdominal fullness and weight loss in December 2005. He underwent conservative therapy with total parenteral nutrition (TPN). In August 2006, his high fever and abdominal fullness became aggravated, suggesting acute peritonitis. Abdominal X ray imaging showed on enlarged intestine and subphrenic free air, but not peritonitis irritation. He was eventually diagnosed with pneumatosis cystoides intestinalis (PCI) with CUP. Abdominal contrast-enhanced computed tomography (CT) showed no ascites, but indicated a double-layered structure at the small intestinal wall. Ten days after long-tube suction, enhanced CT showed that free air had decreased and PCI had disappeared. Emergency surgery was previously recommended for intestinal obstruction accompanied by free air with PCI because of suspected intestinal perforation. Our case suggests that surgical decision-making be done more circumspectly.

Original language	English
Pages (from-to)	828-832
Number of pages	5
Journal	Japanese Journal of Gastroenterological Surgery
Volume	43
Issue number	8
DOIs	https://doi.org/10.5833/jjgs.43.828
Publication status	Published - 2010 Aug

Keywords

CIIP
Diffuse peritonitis
PCI

ASJC Scopus subject areas

Surgery
Gastroenterology

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10.5833/jjgs.43.828

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title = "A Case of pneumatosis cystoides intestinalis with chronic idiopathic intestinal pseudoobstruction",

abstract = "A 23-years-old man diagnosed in childhood as having chronic idiopathic intestinal pseudoobstruction (CUP) and admitted for abdominal fullness and weight loss in December 2005. He underwent conservative therapy with total parenteral nutrition (TPN). In August 2006, his high fever and abdominal fullness became aggravated, suggesting acute peritonitis. Abdominal X ray imaging showed on enlarged intestine and subphrenic free air, but not peritonitis irritation. He was eventually diagnosed with pneumatosis cystoides intestinalis (PCI) with CUP. Abdominal contrast-enhanced computed tomography (CT) showed no ascites, but indicated a double-layered structure at the small intestinal wall. Ten days after long-tube suction, enhanced CT showed that free air had decreased and PCI had disappeared. Emergency surgery was previously recommended for intestinal obstruction accompanied by free air with PCI because of suspected intestinal perforation. Our case suggests that surgical decision-making be done more circumspectly.",

keywords = "CIIP, Diffuse peritonitis, PCI",

author = "Taku Kitayama and Tetsuyuki Uchiyama and Tomoya Abe and Tatsuya Ueno and Masaru Ohnuma and Chikashi Shibata and Hideo Ise and Mika Watanabe",

year = "2010",

month = aug,

doi = "10.5833/jjgs.43.828",

language = "English",

volume = "43",

pages = "828--832",

journal = "Japanese Journal of Gastroenterological Surgery",

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AU - Kitayama, Taku

AU - Uchiyama, Tetsuyuki

AU - Abe, Tomoya

AU - Ueno, Tatsuya

AU - Ohnuma, Masaru

AU - Shibata, Chikashi

AU - Ise, Hideo

AU - Watanabe, Mika

PY - 2010/8

Y1 - 2010/8

N2 - A 23-years-old man diagnosed in childhood as having chronic idiopathic intestinal pseudoobstruction (CUP) and admitted for abdominal fullness and weight loss in December 2005. He underwent conservative therapy with total parenteral nutrition (TPN). In August 2006, his high fever and abdominal fullness became aggravated, suggesting acute peritonitis. Abdominal X ray imaging showed on enlarged intestine and subphrenic free air, but not peritonitis irritation. He was eventually diagnosed with pneumatosis cystoides intestinalis (PCI) with CUP. Abdominal contrast-enhanced computed tomography (CT) showed no ascites, but indicated a double-layered structure at the small intestinal wall. Ten days after long-tube suction, enhanced CT showed that free air had decreased and PCI had disappeared. Emergency surgery was previously recommended for intestinal obstruction accompanied by free air with PCI because of suspected intestinal perforation. Our case suggests that surgical decision-making be done more circumspectly.

AB - A 23-years-old man diagnosed in childhood as having chronic idiopathic intestinal pseudoobstruction (CUP) and admitted for abdominal fullness and weight loss in December 2005. He underwent conservative therapy with total parenteral nutrition (TPN). In August 2006, his high fever and abdominal fullness became aggravated, suggesting acute peritonitis. Abdominal X ray imaging showed on enlarged intestine and subphrenic free air, but not peritonitis irritation. He was eventually diagnosed with pneumatosis cystoides intestinalis (PCI) with CUP. Abdominal contrast-enhanced computed tomography (CT) showed no ascites, but indicated a double-layered structure at the small intestinal wall. Ten days after long-tube suction, enhanced CT showed that free air had decreased and PCI had disappeared. Emergency surgery was previously recommended for intestinal obstruction accompanied by free air with PCI because of suspected intestinal perforation. Our case suggests that surgical decision-making be done more circumspectly.

KW - CIIP

KW - Diffuse peritonitis

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A Case of pneumatosis cystoides intestinalis with chronic idiopathic intestinal pseudoobstruction

Abstract

Keywords

ASJC Scopus subject areas

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