Endoscopic ultrasound diagnosis of pneumatosis cystoides coli initially misdiagnosed as colonic polyps

Bamakhrama, Khaled; Abdulhady, Luka; Vilmann, Peter

doi:10.1055/s-0034-1365152

Cited by 9 publications

(14 citation statements)

References 3 publications

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“…Among them, the three most well-accepted hypotheses are the pulmonary, mechanical, and bacterial theories. [ 7 ] Pulmonary theory suggests that chronic lung diseases, such as COPD and asthma, may rupture alveoli, causing mediastinal emphysema and trapping gas into the intestinal wall along the aorta and mesenteric vessels. The mechanical theory refers to the increased intraluminal pressure caused by intestinal obstruction or other diseases that can lead to mucosal damage and promote cyst formation.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

Pneumatosis cystoides intestinalis

et al. 2022

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“…1 The first reported case of ultrasound being used to diagnose IP was in 1985. 2 Most of the reports use endoscopic ultrasound [3][4][5] or advanced Doppler imaging techniques, 1 which are beyond the purview of the intensivist. On abdominal ultrasound, the circle sign 6 was described in three patients, with the pattern being recognized when extensive gas bubbles were seen in the entire circumference of the bowel wall.…”

Section: Discussionmentioning

confidence: 99%

A 26-Year-Old Man on Prolonged Mechanical Ventilatory Support With a Sudden Elevation in Peak Pressures

Singh

Narasimhan

2017

CHEST

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“…Endoscopic ultrasound examination can therefore be a useful adjunct to colonoscopy to facilitate diagnosis while avoiding radiation. 3 In rare instances, identification of pneumatosis intestinalis is an important surrogate marker for intestinal ischemia and impending perforation, which requires emergent surgical management. 2 However, the majority of cases found are asymptomatic and do not warrant further management such as this case.…”

Section: Answer To: Image 3 (Page 940): Pneumatosis Cystoides Intestimentioning

confidence: 99%