Pneumatosis Cystoides Intestinalis Following Steriod Pulse Therapy in a Patient with Polyarteritis Nodosa

Abstract

We present a case of a 67‐year‐old female with polyarteritis nodosa, complicated by pneumatosis cystoides intestinalis. The definite diagnosis of polyarteritis nodosa was obtained by histological findings on a biopsy specimen from her sural nerve. Following steroid pulse therapy, she developed gastrointestinal symptoms such as nausea, abdominal fullness and watery diarrhea. Abdominal X‐ray and computed tomography showed an abundance of gas contrast within the large intestinal wall. Colonoscopy revealed submucosal tumor‐like multiple elevated lesions from the sigmoid to transverse colon. These findings indicated pneumatosis cystoides intestinalis and the patient was accordingly treated with a high concentration of oxygen via a nasal catheter. One week later, her symptoms and the gas in the bowel wall completely disappeared. Pneumatosis cystoides intestinalis may be one of the complications of steroid pulse therapy.