Pneumatosis Coli Mimicking Colorectal Cancer

Abstract

Pneumatosis coli (PC) is a rare condition of the gastrointestinal tract involving extraluminal gas confined within the bowel wall. We report the case of a 40-year-old gentleman presenting clinically and endoscopically with suspected colorectal cancer. In light of the patient's red flag symptoms, and carpet of polyps seen endoscopically, surgical management by an anterior resection was performed with the patient making a successful recovery. Histological analysis of the resected specimen confirmed pneumatosis coli with no evidence of colonic neoplasia. Although PC can be an incidental finding in asymptomatic patients and considered a benign condition, it can also present as a life-threatening emergency with bowel necrosis and obstruction requiring emergency surgical intervention. Also, when PC mimics malignancy, surgical management is the most appropriate step to ensure that the diagnosis of cancer is not missed.

Rare presentation of benign idiopathic pneumatosis cystoides intestinalis mimicking colonic polyposis

“…Primary or idiopathic PCI is a rare condition that accounts for only less than 15% of all the reported cases [2]. Although Idiopathic PCI can present with or without related intestinal symptoms, the literature review showed that most of the reported cases have presented with symptoms [2][3][4][5].…”