2018, Number 4
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ABSTRACTBackground: Pneumatosis cystoides intestinalis is an infrequent condition, characterized by the formation of gaseous content cysts under the mucosa and intestinal serous. Clinical case: 84-year-old woman, with a history of rheumatoid arthritis under immunosuppressive treatment, operated 2 years ago by pneumoperitoneum, where she was diagnosed of jejunal diverticulosis and mesenteric emphysema, with diffuse abdominal pain of 2 days of evolution, without other symptoms. In abdominal radiography: pneumoperitoneum with elevation of right hemidiaphragm and distention of small intestine. Given the suspicion of perforation of the intestinal wall, surgical intervention was decided, in which the patient was diagnosed with pneumatosis cystoides intestinalis. Conclusion: Pneumatosis cystoides intestinalis has an unknown etiology, although in a high percentage of patients it has been associated with obstructive pulmonary pathologies, connective tissue diseases, immunosuppression or gastrointestinal diseases. It is located more frequently in the colon and small intestine. It is diagnosed mainly through imaging tests (radiography or computed tomography). The treatment is conservative, performing surgical intervention if there is suspicion of intestinal necrosis; being difficult the differential diagnosis with a pneumoperitoneum by perforation of hollow viscera..
Beall D. Pneumatosis intestinalis: a review. Radiology. 1996;199:702.
Brun A. Pneumatosis cystoides intestinalis. Acta Pathol Microbiol Scand. 2009;53:243-52.
Kunishi Y, Ota M, Kato Y, Maeda S. Pneumatosis cystoides intestinalis: lung window setting on CT. Clin Case Rep. 2017;5:1896-7.
Ooi SM. Pneumoperitoneum in a non-acute abdomen-pneumatosis cystoides intestinalis. Surg Case Rep. 2015;1:44.
Wada K, Takeuchi N, Emori M, Takada M, Nomura Y, Otsuka A. Two cases of pneumatosis cystoides intestinalis with intraperitoneal free air. Gastroenterol Res. 2017;10:208-11.
Wu LL, Yang YS, Dou Y, Liu QS. A systematic analysis of pneumatosis cystoides intestinalis. World J Gastroenterol. 2013;19:4973-8.
Pacheco Llerena R, Galindo Gómez J, Luna Valdez C, González Uzieda L, Fernández Hinojosa R, Mendieta Ampuero J, et al. Neumatosis quística intestinal: a propósito de un caso. Rev Soc Bol Ped. 2004;43:15-7.