Pneumatosis cystoides intestinalis: Pilor stenozuna eşlik eden bir olgu sunumu

Pneumatosis cystoides intestinalis: A case report associated with pyloric stenosis

Özet

Pneumatosis cystoidcs intestinalis, karında serbest hava tablosu ile karşımıza çıkabilen, klinikte sıklıkla içi boş organ perforasyonunu düşündüren, oldukça ender bir klinik tablodur. Gerek klinik gerekse radyolojik tanısı oldukça güçtür. Genellikle sekonder olarak ortaya çıkan bu tablo nedeniyle kliniğimizde tedavi ettiğimiz bir olgumuzu literatür bilgileri ışığında sunmak istedik.

Abstract

In this study we discussed a case of pneumatosis cystoides intestinalis in a 50 years old female patient with pyloric stenosis presented with free air in the abdomen. During the operation we observed pyloric stenosis due to peptic ulcus and pneumatosis cystoides intestinalis. We performed BTV + Antrectomy + Gastrojejunostomi + Braun for pyloric stenosis but conservative treatment was preferred instead of a surgical intervention for pneumatosis cystoides intestinalis. Pneumatosis cystoides intestinalis is a rare clinical entity, giving rise to free air within the abdomen suggesting an organ perforation, it is characterised by cysts full of gas within the intestinal wall. Fifteen percent of cases are primary and idiopathic, and 85 % of cases are secondary. Secondary cases are usually related to peptic ulcer, pyloric stenosis, inflammatory bowel disease, infectious gastroenteritis or colitis, connective tissue disorders, steroid therapy, intestinal obstruction, diverticulitis, chronic obstructive pulmonary diseases, acute leukemia, lymphoma and AIDS. Treatment is conservative in primary cases and treatment of underlying disease in secondary cases.