Pneumatosis Cystoids Intestinalis

Excerpt

An asymptomatic 36-year-old woman underwent a screening colonoscopy. The abdominal examination was essentially normal. Multiple translucent polypoid lesions were found in the wall of the ascending and transverse colon (Fig. 1A, B, C). Endoscopic ultrasonography showed a honeycomb-like cluster of air-filled sacs within the right colonic wall (Fig. 1D), which was well defined by plain radiography and computed tomographic imagings of the abdomen (Fig. 2A, B, C, D). These findings termed pneumatosis cystoids intestinalis. She denied any history of medical disorders and denied any medication use. Laboratory investigations were unremarkable. No intra-abdominal collection or portal venous gas was found. These subserosal and submucosal air-filled blebs were a benign finding with no apparent precipitating cause for the patient. Alternatively, gastrointestinal infection, inflammatory bowel disease, obstructive lung disease, and life-threatening intra-abdominal catastrophe may lead to pneumatosis cystoids intestinalis. Primary idiopathic pneumatosis cystoids intestinalis is a radiologic or endoscopic ultrasonography finding, characterized by the presence of gas in the bowel wall, which is usually asymptomatic and diagnosed incidentally [1]. However, patients with secondary life-threatening causes of pneumatosis cystoids intestinalis are usually symptomatic and commonly need operative treatment [2]. Computerized tomography and endoscopic ultrasonography are the most sensitive imaging tests for identification [3]. There remains little evidence to date supporting any of the therapeutic modalities due to the rarity of the condition. She refused any therapeutic schedule and remained well on outpatient follow-up evaluation.

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