Journals / Journal of Surgery and Medicine / 2018 / Cilt: 2 Sayı: 3

Cystic intestinal pneumatosis revealed by peritonitis in perforated peptic ulcer: A case report

Perfore peptik ülserde peritonit ile ortaya çıkan kistik intestinal pnömatozis: Olgu sunumu

Dandakoye Soumana Ismael(Department of visceral surgery ,Hassan II University hospital,Fez)0000-0003-2451-4199
Anas Belhaj(Department of visceral surgery ,Hassan II University hospital,Fez)
Moussa Sylla(Department of visceral surgery ,Hassan II University hospital,Fez)
Somuah Tenkorang(Department of visceral surgery ,Hassan II University hospital,Fez)
Mouaqit Ouadii(Department of visceral surgery ,Hassan II University hospital,Fez)
İmane Toughrai(Department of visceral surgery ,Hassan II University hospital,Fez)
Hassan Moulay Farih(Department of visceral surgery ,Hassan II University hospital,Fez)
Khalid Mazaz(Department of visceral surgery ,Hassan II University hospital,Fez)
Ait Taleb Khalid(Department of visceral surgery ,Hassan II University hospital,Fez)
Pages
377–379
Publication Date
2018-09-01
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Surgery remains reserved for serious forms of this disease.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Cystic intestinal pneumatosis is a rare condition characterized by the presence of cyst-like formations in the walls of the digestive tract.
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Key Findings & Data:This pathology is more common in men and after the age of 50 years.
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Conclusion & Impact:Surgery remains reserved for serious forms of this disease.
🔬Design:Olgu Sunumu
📍Scope:Comprehensive Sample
⚙️Variables:Kistik bağırsak pnömatozu · Kist · Pnömoperiton

Abstract

Cystic intestinal pneumatosis is a rare condition characterized by the presence of cyst-like formations in the walls of the digestive tract. Cystic intestinal pneumatosis can affect any part of the digestive tract. However, the small and large bowels are the most affected. This pathology is more common in men and after the age of 50 years. Cystic pneumatosis of the intestines may be idiopathic or most often secondary to various diseases. The primitive forms preferentially affect the left colon with essentially submucous gaseous cysts, whereas the secondary intestinal cystic pneumatosis tend to affect the small intestines especially in the subserosa. The origin of this pathology is multifactorial but the main cause is not definitively proven. The long list of pathological associations has led to the development of various etiopathogenic theories that are not antinomic since some mechanisms may be associated. Cystic intestinal pneumatosis is most often asymptomatic and therefore fortuitously discovered. This pathology could have clinical signs like bloody and glairy stools, abdominal pain, and diarrhea. Endoscopic and radiological examinations are easy to diagnose and avoid unnecessary laparotomy explorations in benign pneumoperitoneum. Treatment varies according to its etiology. For primary forms, antibiotic therapy to reduce the hydrogen-producing colonic flora is indicated as first-line treatment. If unsuccessful, oxygen mask or hyperbaric, which will promote the replacement of hydrogen with oxygen, must be attempted. For secondary forms, the treatment is that of the causal affection. In most cases, cystic intestinal pneumatosis is asymptomatic and no treatment is needed. Surgery remains reserved for serious forms of this disease.

Özet

Kistik bağırsak pneumatosisis sindirim sistemi duvarlarında kist benzeri oluşumların varlığı ile karakterize nadir bir durumdur. Kistik bağırsak pnömotozu sindirim sisteminin herhangi bir bölümünü etkileyebilir. Bununla birlikte, küçük ve büyük bağırsaklar en çok etkilenenlerdir. Bu patoloji erkeklerde ve 50 yaşından sonra daha yaygındır. Bağırsakların kistik pnömatozu, idiopatik veya çoğu zaman çeşitli hastalıklara ikincil olabilir. İlkel formlar, esas olarak submukozlu gazlı kistler ile sol kolonunu tercih ederler, oysa sekonder intestinal kistik pnömatozlar, özellikle ince bağırsakların subserozasını etkileme eğilimindedir. Bu patolojinin kökeni çok faktörlüdür, ancak ana sebep kesin olarak kanıtlanmamıştır. Patolojik ilişkilerin uzun listesi, çeşitli etiyopatojenik teorilerin gelişmesine yol açmıştır. Kistik bağırsak pnömotozu en sık asemptomatiktir ve bu nedenle tesadüfi bir şekilde saptanır. Bu patoloji kanlı dışkılama, karın ağrısı ve diyare gibi klinik belirtilere sahip olabilir. Endoskopik ve radyolojik incelemeler benign pnömoperitoneumda gereksiz laparotomi eksplorasyonlarını tespit etmek ve önlemek için faydalıdır. Tedavi etiyolojisine göre değişir. Birincil formlar için, hidrojen üreten kolonik florayı azaltmak için antibiyotik tedavisi, birinci basamak tedavi olarak belirtilmektedir. Başarısız ise, oksijen ile oksijen değiştirilmesini teşvik edecek oksijen maskesi veya hiperbarik tedavi denenmelidir. Sekonder formlar için tedavi, nedensel olarak değişkendir. Çoğu durumda, kistik bağırsak pnömatozu asemptomatiktir ve tedaviye gerek yoktur. Cerrahi, bu hastalığın ciddi formları için ayrılmıştır.

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Cite This Article

Ismael, D. S., Belhaj, A., Sylla, M., Tenkorang, S., Ouadii, M., Hassani, İ. M., Toughrai, İ., Farih, H. M., Mazaz, K., Khalid, A. T. (2018). Cystic intestinal pneumatosis revealed by peritonitis in perforated peptic ulcer: A case report. Journal of Surgery and Medicine, Cilt: 2 Sayı: 3, 377–379. https://doi.org/10.28982/josam.426196

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References (23)

  1. Boerner RM, Fried DB, Warshauer DM, Isaacs K. Pneumatosis intestinalis. Two case reports and a retrospective review of the literature from 1985 to 1995. Dig Dis Sci. 1996;41:2272-85.
  2. Danse EM, Vanbeers BE, Gilles A, Jacquet I. Sonographic detection of intestinal pneumatosis. Eur J ultrasound 2000;11:201-03.
  3. Rybacj LD, Shopiro RS, Carano K, Halton KP. Massive pneumatosisintestinalis: CT diagnosis. Comput Med Imaging Graph. 1999;23:165-8.
  4. Xavier JL, Boscangi G, Claudel N, et al. La pneumatose kystique intestinale. Ann Radiol. 1991;34:401-6.
  5. Kaassis M, Ben bouali A, Arnaud JP. Pneumatose kystique occlusive du côlon gauche (quelle attitude thérapeutique faut-il adopter?). J Chir. 1995;132:183-5.
  6. Vernoi JG Du. AnatomischeBeobachtung under der Æussen und innern Haut der Gedaermeeingeschlossenen. Luft Phys Med Abhandl Acad Wisseusch Petersb. 1783;2:182.
  7. Jamart J. Pneumatosiscystoides intestinalis-A statistical study of 919 cases. ActaHepatogastroenterol (Stuttg). 1979;26(5):419–22.
  8. Holt S, Stewart IC, Heading RC, Macpherson AI. Resolution of primary pneumatosis coli. J R Coll Surg Edinb. 1978;23(5):297–9.
  9. Heng Y, Schuffler MD, Haggitt RC, Rohrmann CA. Pneumatosis intestinalis: a review. Am J Gastroenterol. 1995;90(10):1747–58.
  10. Grasland A, Pouchot J, Leport J, Barge J, Vinceneux P. Pneumatosiscystoidesintestinalis. Presse Med. 1998;27(35):1804–12.
  11. Guillem P. Radiologic pneumoperitoneum without perforation of a hollow viscus. J Chir (Paris). 2002;139(1):5–15.
  12. Quintart C, Choghari C, Michez D, Lefebvre P, Ramdani B. Pneumatosiscystoides intestinalis - Diagnostic elements and therapeutic approach. Ann Chir. 1997;15(9):1032–5.
  13. Boland C, De Ronde T, Lacrosse M, Trigaux JP, Delaunois L, Melange M. Pneumatosiscystoides intestinalis associated with Steinert disease. Gastroenterol Clin Biol. 1995;19(3):305–8.
  14. Levitt MD, Olsson S. Pneumatosiscystoides intestinalis and high breath H2 excretion: insights into the role of H2 in this condition. Gastroenterology. 1995;108(5):1560–5.
  15. Meikle G. A case of pneumatosis coli: pneumatosiscystoides intestinalis of the sigmoid colon causing intestinal obstruction, stercoral ulcer and perforation. J R Coll Surg Edinb. 1965;11(1):65–7.
  16. Estermann F, Denis B, Gaucher P, Regent D, Sondag D. Pneumatosiscystoides of the colon: knowing how to recognize it -Apropos of 8 cases. Ann Gastroenterol Hepatol (Paris). 1994;30(4):151–5.
  17. Pun YL, Russell DM, Taggart GJ, Barraclough DR. Pneumatosis intestinalis and pneumoperitoneum complicating mixed connective tissue disease. Br J Rheumatol. 1991;30(2):146–9.
  18. Scheidler J, Stabler A, Kleber G, Neidhardt D. Computed tomography in pneumatosis intestinalis: differential diagnosis and therapeutic consequences. Abdom Imaging. 1995;20(6):523–8.
  19. Brientini F, Debilly M, Litzler JF, Raclot G, Le Mouel A. Colonic cystic pneumatosis -A specific x-ray computed tomographic diagnosis: apropos of 2 cases. J Radiol. 1995;76(2-3):135–40.
  20. Kohzaki S, Hayashi K, Fukuda T, Uetani M, Kawano Y, Iriarte WL. Case report: the "aurora sign"--a new sonographic sign of pneumatosiscystoides intestinalis. Br J Radiol. 1994;67(804):1275–7.
  21. Feczko PJ, Mezwa DG, White BD. Clinical significance of pneumatosis of the bowel wall. Radiographics. 1992;12(6):1069–78.
  22. Rogy MA, Mirza DF, Kovats E, Rauhs R. Pneumatosiscystoidesintestinalis (PCI). Int J Colorectal Dis. 1990;5(2):120–4.
  23. Boerner RM, Fried DB, Warshauer DM, Isaacs K. Pneumatosis intestinalis -Two case reports and a retrospective review of the literature from 1985 to 1995. Dig Dis Sci. 1996;41(11):2272–85.