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Digestive Diseases and Sciences

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13.08.2019 | DDS–SIRC COOPERATIVE CONFERENCES

“Cystamatic” Review: Is Surgery Mandatory for Pneumatosis Cystoides Intestinalis?

verfasst von: M. Brighi, S. Vaccari, A. Lauro, V. D’Andrea, N. Pagano, I. R. Marino, M. Cervellera, V. Tonini

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2019

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Abstract

Introduction

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of intramural gas cysts within the small and large intestines. We describe a case of a 70-year-old man admitted to the Emergency Surgery Department for PCI who was treated conservatively.

Areas Covered

We reviewed 60 cases of PCI described in the international literature over the last 5 years. From our analysis, it appears that the etiology of the gas production within the submucosa or the subserosa of the gastrointestinal tract is still unknown. The rupture of the cysts can lead to pneumoperitoneum that can simulate a surgical emergency.

Expert Commentary

For patients with PCI, a conservative approach is the treatment of choice, with surgery mandatory only for complicated disease.

Du Vernoy JG. Aer intestinorum tam sub extima quam intima tunica inclusus: observationes anatomicae: comment. Acad Acient Imp Petropol. 1730;5:213–225.

Rahim H, Khan M, Hudgins J, et al. Gastrointestinal sarcoidosis associated with pneumatosis cystoides intestinalis. World J Gastroenterol. 2013;19:1135–1139.CrossRefPubMedPubMedCentral

Rodríguez-Sánchez D, Sáez-Martínez ME, Sánchez-Jiménez RM, et al. Pneumatosis cystoides, CT colonoscopy and endoscopic correlation. Rev Esp Enferm Dig. 2013;105:486–487. https://doi.org/10.4321/S1130-01082013000800007.CrossRefPubMed

Wu LL, Yang YS, Dou Y, et al. A systematic analysis of pneumatosis cystoides intestinalis. World J Gastrenterol. 2013;19:4973–4978.CrossRef

Morris MS, Gee AC, Co SD, et al. Management and outcome of pneumatosis intestinalis. Am J Surg. 2008;195:679–682.CrossRefPubMed

Korhonen K, Lovvorn HN, Koyama T, et al. Incidence, risk factors, and outcome of pneumatosis intestinalis in pediatric stem cell transplant recipients. Pediatr Blood Cancer. 2012;58:616–620.CrossRefPubMed

Ivanović A, Kovač J, Mašulović D, et al. Education and imaging. Gastrointestinal: the role of multidetector computer tomography in diagnosis of pneumatosis cystoides intestinalis. J Gastrenterol Hepatol. 2012;27:182.CrossRef

Ooi SM. Pneumoperitoneum in a non-acute abdomen-pneumatosis cystoides intestinalis. Surg Case Rep. 2015;1:44.CrossRefPubMedPubMedCentral

Torigoe K, Arai H, Yamashita A, et al. Improvements in pneumatosis cystoides intestinalis an hepatic portal venous gas with conservative therapy in a patient on maintenance dialysis. Inter Med. 2016;55:1735–1738.CrossRef

10.

Wayne E, Ough M, Wu A, et al. Management algorithm for pneumatosis intestinalis and portal venous gas: treatment and outcome of 88 consecutive cases. J Gastrointest Surg. 2010;14:437–448.CrossRefPubMed

11.

Mitsuyoshi Y, Takakura K, Kobayashi T, et al. Chronic intestinal pseudo-obstruction with pneumatosis cystoides intestinalis in a patient with systemic sclerosis: a case report. Medicine. 2019;98:e15480. https://doi.org/10.1097/MD.0000000000015480.CrossRefPubMedPubMedCentral

12.

Lin WC, Wang KC. Pneumatosis cystoides intestinalis secondary to use of an α-glucosidase inhibitor. Radiology. 2019;290:619. https://doi.org/10.1148/radiol.2019182186.CrossRefPubMed

13.

Takahashi K, Fujiya M, Ueno N, et al. Endoscopic fine-needle aspiration is useful for the treatment of pneumatosis cystoides intestinalis with intussusception. Am J Gastroenterol. 2019;114:13. https://doi.org/10.14309/ajg.0000000000000069.CrossRefPubMed

14.

Singh G, Johnson C, Gill R, et al. Pneumatosis cystoides intestinalis (PCI) in a patient with undiagnosed systemic sclerosis. BMJ Case Rep. 2018;28:2018. https://doi.org/10.1136/bcr-2018-225175.CrossRef

15.

Asahi Y, Suzuki T, Sawada A, et al. Pneumatosis cystoides intestinalis secondary to sunitinib treatment for gastrointestinal stromal tumor. Case Rep Gastroenterol. 2018;12:432–438. https://doi.org/10.1159/000490657.CrossRefPubMedPubMedCentral

16.

Uruga H, Moriguchi S, Takahashi Y, et al. Gefitinib successfully administered in a lung cancer patient with leptomeningeal carcinomatosis after erlotinib-induced pneumatosis intestinalis. BMC Cancer. 2018;18:825. https://doi.org/10.1186/s12885-018-4743-5.CrossRefPubMedPubMedCentral

17.

Koysombat K, Capanna MV, Stafford N, et al. Combination therapy for systemic sclerosis-associated pneumatosis intestinalis. BMJ Case Rep. 2018;. https://doi.org/10.1136/bcr-2018-225068.CrossRefPubMed

18.

Wang YJ, Wang YM, Zheng YM, et al. Pneumatosis cystoides intestinalis: six case reports and a review of the literature. BMC Gastroenterol. 2018;18:100. https://doi.org/10.1186/s12876-018-0794-y.CrossRefPubMedPubMedCentral

19.

Martín-Lagos Maldonado A, Lozano Cejudo C, Sáenz Lozano A. A pneumoperitoneum due to intestinal cystic pneumatosis associated with a tyrosine kinase inhibitor. Rev Esp Enferm Dig. 2018;110:531–532. https://doi.org/10.17235/reed.2018.5588/2018.CrossRefPubMed

20.

Suda T, Shirota Y, Wakabayashi T. Pneumatosis cystoides intestinalis. Clin Gastroenterol Hepatol. 2019;17:A33–A34. https://doi.org/10.1016/j.cgh.2018.05.012.CrossRefPubMed

21.

Márquez Argente Del Castillo B, Olalla Muñoz JR. Focal Pneumatosis cystoides intestinalis: optic colonoscopy and virtual colonoscopy features. Rev Esp Enferm Dig. 2018;110:411.PubMed

22.

de la Serna S, Luna A, de la Rosa H. Intestinal pneumatosis and pneumoperitoneum in an oncological scenario: a change of attitude. Rev Esp Enferm Dig. 2018;110:68–69. https://doi.org/10.17235/reed.2017.5333/2017.CrossRefPubMed

23.

Mikami T, Kakimoto K, Hirata Y, et al. Pneumatosis cystoides intestinalis in a patient with ulcerative colitis. J Gastrointestin Liver Dis. 2017;26:337. https://doi.org/10.15403/jgld.2014.1121.264.hig.CrossRefPubMed

24.

Sugihara Y, Okada H. Pneumatosis cystoides intestinalis. N Engl J Med. 2017;377:2266. https://doi.org/10.1056/NEJMicm1701357.CrossRefPubMed

25.

Kunishi Y, Ota M, Kato Y, et al. Pneumatosis cystoides intestinalis: lung window setting on CT. Clin Case Rep. 2017;5:1896–1897. https://doi.org/10.1002/ccr3.1151.CrossRefPubMedPubMedCentral

26.

Lee YS, Han JJ, Kim SY, et al. Pneumatosis cystoides intestinalis associated with sunitinib and a literature review. BMC Cancer. 2017;17:732. https://doi.org/10.1186/s12885-017-3744-0.CrossRefPubMedPubMedCentral

27.

Kang G. Benign pneumatosis intestinalis: Dilemma for primary care clinicians. Can Fam Physician. 2017;63:766–768.PubMedPubMedCentral

28.

Nakatani K, Kato T, Okada S, et al. Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report. J Med Case Rep. 2017;11:263. https://doi.org/10.1186/s13256-017-1421-1.CrossRefPubMedPubMedCentral

29.

Rachapalli V, Chaluvashetty SB. Pneumatosis cystoides intestinalis. J Clin Diagn Res. 2017;11:TJ01–TJ02. https://doi.org/10.7860/JCDR/2017/26197.10087.CrossRefPubMedPubMedCentral

30.

Jegadeesan R, Sundararajan T, Patel MB, et al. Pneumatosis intestinalis due to extrinsic compression from a large renal cyst. Am J Gastroenterol. 2017;112:983. https://doi.org/10.1038/ajg.2017.64.CrossRefPubMed

31.

Liao YH, Lo YP, Liao YK, et al. Pneumatosis cystoides coli related to acarbose treatment. Am J Gastroenterol. 2017;112:984. https://doi.org/10.1038/ajg.2017.88.CrossRefPubMed

32.

Suzuki E, Kanno T, Hazama M, et al. Four cases of pneumatosis cystoides intestinalis complicated by connective tissue diseases. Intern Med. 2017;56:1101–1106. https://doi.org/10.2169/internalmedicine.56.7877.CrossRefPubMedPubMedCentral

33.

Iida A, Naito H, Tsukahara K, et al. Pneumatosis cystoides intestinalis presenting as pneumoperitoneum in a patient with chronic obstructive pulmonary disease: a case report. J Med Case Rep. 2017;11:55. https://doi.org/10.1186/s13256-017-1198-2.CrossRefPubMedPubMedCentral

34.

Romano-Munive AF, Barreto-Zuñiga R. Pneumatosis cystoides intestinalis. Rev Esp Enferm Dig. 2017;109:61.PubMed

35.

Venkataramani V, Seif Amir Hosseini A, Schulze MH, et al. Intestinal pneumatosis associated with tuberculosis after allogeneic hematopoietic stem cell transplantation. Acta Haematol. 2017;137:51–54. https://doi.org/10.1159/000452436.CrossRefPubMed

36.

Faria LD, Anjos CH, Fernandes GD, et al. Pneumatosis intestinalis after etoposide-based chemotherapy in a patient with metastatic small cell lung cancer: successful conservative management of a rare condition. Einstein (Sao Paulo). 2016;14:420–422. https://doi.org/10.1590/S1679-45082016RC3597.CrossRef

37.

Fujimi A, Sakamoto H, Kanisawa Y, et al. Pneumatosis intestinalis during chemotherapy with nilotinib in a patient with chronic myeloid leukemia who tested positive for anti-topoisomerase I antibodies. Clin J Gastroenterol. 2016;9:358–364.CrossRefPubMed

38.

Furihata T, Furihata M, Ishikawa K, et al. Does massive intraabdominal free gas require surgical intervention? World J Gastroenterol. 2016;22:7383–7388. https://doi.org/10.3748/wjg.v22.i32.7383.CrossRefPubMedPubMedCentral

39.

Mima A, Nagahara D, Tansho K. Methotrexate induced pneumatosis intestinalis under hemodialysis patient. Hemodial Int. 2017;21:E9–E12. https://doi.org/10.1111/hdi.12459.CrossRefPubMed

40.

Torigoe K, Arai H, Yamashita A, et al. Improvements in pneumatosis cystoides intestinalis and hepatic portal venous gas with conservative therapy in a patient on maintenance dialysis. Intern Med. 2016;55:1735–1738. https://doi.org/10.2169/internalmedicine.55.6235.CrossRefPubMed

41.

Fraga M, Silva MJND, Lucas M. Idiopathic pneumatosis intestinalis, radiological and endoscopic images. GE Port J Gastroenterol. 2016;23:270–272. https://doi.org/10.1016/j.jpge.2016.01.005.CrossRefPubMedPubMedCentral

42.

Kinjo M. Lurking in the wall: pneumatosis cystoides intestinalis with scleroderma. Am J Med. 2016;129:382–383. https://doi.org/10.1016/j.amjmed.2015.12.007.CrossRefPubMed

43.

Ksiadzyna D, Peña AS. Segmental pneumatosis cystoides coli: computed tomography-facilitated diagnosis. Rev Esp Enferm Dig. 2016;108:510–513. https://doi.org/10.17235/reed.2015.3790/2015.CrossRefPubMed

44.

Helo N, Rhee K, Dugum M. An intriguing case of bright red blood per rectum. Pneumatosis cystoids intestinalis. Gastroenterology. 2015;149:e1–e2. https://doi.org/10.1053/j.gastro.2014.12.037.CrossRefPubMed

45.

Castro-Poças F, Araújo T, Pedroto I. Endoscopic ultrasound of pneumatosis cystoides intestinalis. Endoscopy. 2015;47:E274. https://doi.org/10.1055/s-0034-1391873.CrossRefPubMed

46.

Kancherla D, Vattikuti S, Vipperla K. Pneumatosis cystoides intestinalis: is surgery always indicated? Cleve Clin J Med. 2015;82:151–152. https://doi.org/10.3949/ccjm.82a.14006.CrossRefPubMed

47.

Akasaka H, Wajima N, Kimura A, et al. A case of pneumatosis cystoides intestinalis after neoadjuvant chemotherapy for esophageal cancer. Gan To Kagaku Ryoho. 2014;41:2375–2377. Japanese.PubMed

48.

Ando T, Sakata J, Maruyama T, et al. A case of pneumatosis cystoides intestinalis secondary to gefitinib therapy for lung adenocarcinoma. Gan To Kagaku Ryoho. 2015;42:847–849. Japanese.PubMed

49.

Blair HA, Baker R, Albazaz R. Pneumatosis intestinalis an increasingly common radiological finding, benign or life-threatening? A case series. BMJ Case Rep. 2015;. https://doi.org/10.1136/bcr-2014-207234.CrossRefPubMedPubMedCentral

50.

Chandola R, Elhenawy A, Lien D, et al. Massive gas under diaphragm after lung transplantation: pneumatosis intestinalis simulating bowel perforation. Ann Thorac Surg. 2015;99:687–689. https://doi.org/10.1016/j.athoracsur.2014.03.047.CrossRefPubMed

51.

Aziret M, Erdem H, Ülgen Y, et al. The appearance of free-air in the abdomen with related pneumatosis cystoides intestinalis: three case reports and review of the literature. Int J Surg Case Rep. 2014;5:909–913. https://doi.org/10.1016/j.ijscr.2014.09.031.CrossRefPubMedPubMedCentral

52.

Klimova K, Pérez Valderas MD, Merino Rodríguez B, et al. Pneumatosis cystoides intestinalis as an infrequent cause of chronic abdominal pain. Rev Gastroenterol Mex. 2014;79:302–303. https://doi.org/10.1016/j.rgmx.2014.09.001.CrossRefPubMed

53.

Rodrigues-Pinto E, Ramalho R, Baldaia H, et al. Pneumatosis cystoides intestinalis secondary to increased intraluminal air pressure of previous colonoscopies. Endoscopy. 2014;46:E572–E573. https://doi.org/10.1055/s-0034-1377985.CrossRefPubMed

54.

Santos-Antunes J, Ramalho R, Lopes S, et al. Asymptomatic pneumatosis cystoides intestinalis diagnosed in the follow-up of a dysplastic polyp. Endoscopy. 2014;46:E425–E426. https://doi.org/10.1055/s-0034-1377435.CrossRefPubMed

55.

Yao SY, Seo R, Nagano T, et al. Pneumatosis cystoides intestinalis associated with toxic epidermal necrolysis: a case report. World J Clin Cases. 2014;2:469–473. https://doi.org/10.12998/wjcc.v2.i9.469.CrossRefPubMedPubMedCentral

56.

Tseng PY, Tarng DC, Yang WC, et al. Benign pneumatosis intestinalis. Intern Med. 2014;53:1589–1590.CrossRefPubMed

57.

Bamakhrama K, Abdulhady L, Vilmann P. Endoscopic ultrasound diagnosis of pneumatosis cystoides coli initially misdiagnosed as colonic polyps. Endoscopy. 2014;46:E195–E196. https://doi.org/10.1055/s-0034-1365152.CrossRefPubMed

58.

Ohtake S, Namura K, Fujikawa A, et al. A case of pneumatosis cystoides intestinalis secondary to sunitinib treatment for renal cell carcinoma. Hinyokika Kiyo. 2014;60:75–78. Japanese.PubMed

59.

Jurado-Román M, Calero-García P, Flores-Garnica LM, et al. Pneumatosis cystoides intestinalis. Uncommon cause of pneumoperitoneum. Rev Esp Enferm Dig. 2014;1060:71–72.CrossRef

60.

Rodrigues-Pinto E, Pereira P, Macedo G. Primary pneumatosis cystoides intestinalis (with video). Gastrointest Endosc. 2014;79:1008–1010. https://doi.org/10.1016/j.gie.2014.01.027.CrossRefPubMed

61.

Cottom H, Ford AC, Rotimi O. Masquerading gastrointestinal polyps: air on the side of caution? Cystic pneumatosis. Gastroenterology. 2014;146:e9–10. https://doi.org/10.1053/j.gastro.2013.11.043.CrossRefPubMed

Titel: “Cystamatic” Review: Is Surgery Mandatory for Pneumatosis Cystoides Intestinalis?
verfasst von: M. Brighi
S. Vaccari
A. Lauro
V. D’Andrea
N. Pagano
I. R. Marino
M. Cervellera
V. Tonini
Publikationsdatum: 13.08.2019
Verlag: Springer US
Erschienen in: Digestive Diseases and Sciences / Ausgabe 10/2019
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI: https://doi.org/10.1007/s10620-019-05767-4

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Abstract

Introduction

Areas Covered

Expert Commentary

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