Three cases of innocuous pneumatosis intestinalis (IPI) of the right colon occurred in a series of 218 renal transplant recipients over a five-year period. Each of the three transplants was in the right iliac fossa. Clinically, these patients had little or no gastrointestinal symptoms and had normal physical examinations of the abdomen. One of the patients had a generalized herpes simplex type 2 (HSV II) infection. Cystic or linear lucencies were present within the bowel wall, associated with varying degrees of localized colonic distention. The condition (IPI) did not warrant surgical intervention or reduction of immunosuppressive therapy. The pneumatosis resolved over a period of several weeks without sequelae or recurrence.
Radiographs of the stomach showed narrowing of the antrum, caused by toxoplasmosis, in a patient with acquired immunodeficiency syndrome (AIDS). A biopsy specimen demonstrated numerous cysts containing Toxoplasma gondii and many free trophozoites. A subsequent brain scan, obtained with computed tomography, showed multiple enhancing lesions throughout the cerebrum, cerebellum, and basal ganglia that were characteristic of toxoplasmosis. Radiographic abnormalities of the stomach are not uncommon in patients with AIDS. They are associated with infections such as cryptosporidiosis and cytomegalovirus and neoplasms such as Kaposi sarcoma and malignant lymphoma. To the authors' knowledge, this is the first reported case of toxoplasmosis involving the stomach.
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