Endoscopic Fine-Needle Aspiration Is Useful for the Treatment of Pneumatosis Cystoides Intestinalis With Intussusception

Takahashi, Keitaro; Fujiya, Mikihiro; Ueno, Nobuhiro; Ando, Koji; Moriichi, Kentaro; Okumura, Toshikatsu

doi:10.14309/ajg.0000000000000069

Cited by 10 publications

(7 citation statements)

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“…Moreover, endoscopic fine-needle aspiration may be useful for the diagnosis and treatment of PCI. Similar to our patient, when puncturing the cyst, the cyst collapsed after the air escaped [8] …”

Section: Discussionsupporting

confidence: 84%

“…Similar to our patient, when puncturing the cyst, the cyst collapsed after the air escaped. [8] The choice of treatment depends on the complications and the underlying causes of PCI. Most cases are considered benign, and only conservative treatments are needed, including oxygen administration, antibiotic therapy, and fluid administration.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have indicated that endoscopic ultrasound (EUS) and endoscopic fine-needle aspiration are useful for the diagnosis and treatment of PCI. [5][6][7][8] Here, we report the case of a 69-year-old man admitted to the gastroenterology department with alternating bowel movements and intermittent bloody stool. PCI was diagnosed using abdominal computed tomography (CT) scan, colonoscopy, and EUS.…”

Section: Introductionmentioning

confidence: 99%

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Pneumatosis cystoides intestinalis

et al. 2022

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Rationale: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas-filled cysts in the intestinal wall, and can be caused by many conditions. Patient concerns: We reported a-69-year-old man with a long history of chronic obstructive pulmonary disease was admitted to the gastroenterology department because of alternating bowel movement and intermittent bloody stool. Diagnoses: Colonoscopy revealed multiple nodular protuberances covered with normal-looking mucosa in the ascending and proximal transverse colon. Abdominal computed tomography scan and endoscopic ultrasound revealed multiple gas-filled cystic lesions in the submucosa. The diagnosis of PCI was confirmed by cyst collapse after puncturing with a fine needle. Interventions and outcomes: Considering that the patient had no peritonitis or other complications, conservative approaches, including oxygen inhalation and oral probiotics, were used. The patient was transferred to the anorectal department after 5days of clinical observation in good condition to further treat hemorrhoids. Lessons: PCI is a rare condition that may be secondary to many other diseases. Because of its atypical clinical manifestations, it can be misdiagnosed as other diseases, such as polyps, inflammatory bowel disease, and even cancer. The diagnosis of PCI depends on computed tomography, colonoscopy, and endoscopic ultrasonography. Fine-needle aspiration may be helpful in the diagnosis and treatment of PCI.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pneumatosis cystoides intestinalis

et al. 2022

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“…The principal symptom was abdominal pain associated with the finding of free air under diaphragm. These [12] 65 years, M Secondary Intake of α-glucosidase inhibitors Takahashi et al [13] 17 years, F Idiopathic -Singh et al [14] N/A, F Secondary Systemic sclerosis Asahi et al [15] 67 years, M Secondary Neoplasm Uruga et al [16] 71 years, F Secondary Neoplasm Koysombat et al [17] N/A Secondary Systemic sclerosis Wang et al [18] 56 years, M Idiopathic -48 years, F Secondary Exposing to trichloroethylene 66 years, F Secondary Disease of immune system 72 years, F Secondary Diabetes 64 years, M Secondary Emphysema 24 years, F Secondary Neoplasm Martin-Lagos et al [19] 72 years, M Secondary Chemotherapy Suda et al [20] 80 years, M Idiopathic -Márquez Argente et al [21] 48 years, M Idiopathic de la Serna et al [22] 83 years, M Secondary Chemotherapy Mikami et al [23] 72 years, M Secondary Ulcerative colitis Sugihara et al [24] 48 years, F Secondary Therapy with glucocorticoid Kunishi et al [25] 84 years, M Secondary Intake of α-glucosidase inhibitors Lee et al [26] 68 years, F Secondary Chemotherapy Kang et al [27] 54 years, M Secondary COPD Nakatani et al [28] 70 years, M Secondary Granulomatosis with polyangiitis Rachapalli et al [29] 50 years, M Secondary Neoplasm Jegadeesan et al [30] 51 years, M Secondary Neoplasm Liao et al [31] 84 years, F Idiopathic -Suzuki et al [32] 71 years, F Secondary Connective tissue disease 70 years, F Secondary Connective tissue disease 70 years, M Secondary Connective tissue disease 42 years, F Secondary Connective tissue disease Iida et al [33] 79 years, M Secondary COPD Romano-Munive et al [34] 54 years, F Idiopathic -Venkataramani et al [35] 56 years, F Secondary Neoplasm Faria et al [36] 69 years, M Secondary Neoplasm Fujimi et al [37] 55 years, M Secondary Interstitial pneumonia with corticosteroid therapy Furihata et al [38] 81 years, M Idiopathic -Mima et al [39] 46 years, M Secondary Rheumatoid arthritis Torigoe et al [40] 77 ...…”

Section: Discussionmentioning

confidence: 99%

“Cystamatic” Review: Is Surgery Mandatory for Pneumatosis Cystoides Intestinalis?

Brighi¹,

Vaccari²,

Lauro³

et al. 2019

Dig Dis Sci

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Introduction Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of intramural gas cysts within the small and large intestines. We describe a case of a 70-year-old man admitted to the Emergency Surgery Department for PCI who was treated conservatively. Areas Covered We reviewed 60 cases of PCI described in the international literature over the last 5 years. From our analysis, it appears that the etiology of the gas production within the submucosa or the subserosa of the gastrointestinal tract is still unknown. The rupture of the cysts can lead to pneumoperitoneum that can simulate a surgical emergency. Expert Commentary For patients with PCI, a conservative approach is the treatment of choice, with surgery mandatory only for complicated disease. Keywords Pneumatosis cystoides intestinalis • Conservative management • Spontaneous pneumoperitoneum Abbreviations CTComputed tomography scan PCI Pneumatosis cystoides intestinalis COPD Chronic obstructive pulmonary disease Case Report and EvolutionA 70-year-old man was admitted to the Emergency Department of St. Orsola University Hospital-Bologna-due to the onset of abdominal pain associated with rectorrhagia. His past medical history included hypertension, atrial fibrillation treated with oral anticoagulants, an episode of stroke with dysphagia and dysarthria, cerebrovascular disease, nephrectomy for renal cancer, and diabetes mellitus. In the emergency department, physical examination, blood tests, and chest X-ray were performed. Physical examination was remarkable for upper abdominal direct tenderness in the * A. Lauro

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“…Fuente: archivo de los autores. casos el tratamiento puede ser conservador mediante observación y seguimiento (4,6,8) , oxigenoterapia hiperbárica (10) , antibióticos (metronidazol, tinidazol, rifaximina, quinolonas), probióticos tipo Bifidobacterium, terapia endoscópica como aspiración con aguja fina (6,11) o resección electroquirúrgica de alta frecuencia de las paredes quísticas o escleroterapia, sin recomendarse el uso de argón plasma debido a la posible explosión por metano (8) , y cambio de quimioterapéuticos (tipo citostáticos o terapias moleculares dirigidas e inhibidores de tirosina-cinasa para patología tumoral metastásica esofágica, pulmonar, renal o de otro tipo) (12) .…”

Section: Caso Clínicounclassified

Neumatosis quística intestinal con neumoperitoneo encapsulado no quirúrgico: presentación de caso y revisión de la literatura

Avellaneda¹,

Ortíz

2023

Rev. colomb. Gastroenterol.

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Introducción: la neumatosis quística intestinal es una entidad infrecuente, caracterizada por la presencia de quistes o burbujas de aire en la pared intestinal, usualmente asintomática. Sus formas no complicadas son manejadas conservadoramente y las graves requieren intervención quirúrgica. La presencia de neumoperitoneo es un hallazgo radiológico inquietante, pero no es indicador de intervención quirúrgica. Caso clínico: hombre de 23 años con pérdida de peso, diarrea y rectorragia, la colonoscopia mostró múltiples quistes violáceos localizados en el sigmoide y descendente que colapsaron tras la punción y biopsias, la tomografía axial computarizada (TAC) confirmó el diagnóstico y la presencia de un neumoperitoneo encapsulado. La ausencia de signos de potencial letalidad permitió un tratamiento conservador con remisión clínica durante los primeros 8 meses de seguimiento. Discusión: la fisiopatología de la neumatosis quística intestinal no está bien definida. En el paciente presentado el diagnóstico se realizó de forma incidental al realizar una colonoscopia por una rectorragia. El neumoperitoneo asintomático encapsulado debe interpretarse como un signo importante pero no determinante de intervención quirúrgica y su presencia junto con los antecedentes médicos, examen físico, bioquímico, endoscópico e imagenológico puede evitar cirugías innecesarias.

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Endoscopic Fine-Needle Aspiration Is Useful for the Treatment of Pneumatosis Cystoides Intestinalis With Intussusception

Cited by 10 publications

References 2 publications

Pneumatosis cystoides intestinalis

Pneumatosis cystoides intestinalis

“Cystamatic” Review: Is Surgery Mandatory for Pneumatosis Cystoides Intestinalis?

Neumatosis quística intestinal con neumoperitoneo encapsulado no quirúrgico: presentación de caso y revisión de la literatura

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