Pneumatosis Cystoides Intestinalis Following Lupus Enteritis and Peritonitis

Abstract

We describe a case of systemic lupus erythematosus (SLE)

A Rare Case of Pneumatosis Cystoides Intestinalis After Appendicectomy

“…Conservative methods include hyperbaric oxygen as routinely used. 12,13 For secondary pneumatosis cystoides intestinalis with or without complication, surgery is indicated. 11 Diagnosing rare benign conditions can be difficult, especially where bowel cancer is part of the differential diagnosis.…”

Pneumatosis Coli Mimicking Colorectal Cancer

“…In a prospective review by Knechtle et al [18], 5 symptoms and signs were predictive of bowel necrosis in patients with PC necessitating surgery:

an acute abdomen per history and examination,

metabolic acidosis,

elevated lactate,

elevated serum amylase,

presence of portal venous gas.

Conservative approaches have been employed in patients with PC especially when asymptomatic and a benign underlying cause is known. In symptomatic patients with normal biochemical parameters and no evidence of bowel ischaemia or perforation, non-operative management has been shown to be beneficial [19]. Conservative methods include the use of nasogastric decompression, antibiotics and oxygen therapy.…”

Pneumatosis cystoides intestinalis in neuropsychiatric systemic lupus erythematosus with diabetes mellitus: case report and literature review

“…The present patient was taking PSL for SLE and voglibose and glimepiride for DM at the time of the development of PCI, and the former 2 medications are particularly important Table 1 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Lupus vasculitis was a main cause of PCI in 7 cases [12,13,15,17,18,20,23], while in 6 others [16,19,21,22,24,25], immunosuppressive drugs, including corticosteroid, were suspected as a causative agent. PCI ascribable to medications seems to preferentially involve the ascending and/or transverse colon, as seen in the present patient [16,21,22,24,25].…”

“…Lupus vasculitis was a main cause of PCI in 7 cases [12,13,15,17,18,20,23], while in 6 others [16,19,21,22,24,25], immunosuppressive drugs, including corticosteroid, were suspected as a causative agent. PCI ascribable to medications seems to preferentially involve the ascending and/or transverse colon, as seen in the present patient [16,21,22,24,25]. PSL, a corticosteroid, reduces lymphocytes in the gastrointestinal wall, particularly in Peyer's patches, and impairs the bowel barrier system [27].…”

“…Mucosal infection or injury may easily cause penetration of intraluminal air into the intestinal wall, leading to the development of PCI. Highdose corticosteroid and its long-term use have been reported as an essentially harmful factor causing PCI in SLE [16,19,21,22,24,25], as well as other autoimmune disorders, such as inflammatory myopathy [28,29]. Voglibose, an aGI, reduces the absorption speed of carbohydrates from the intestine, and acts as an anti-diabetic drug.…”