Pneumatosis cystoides intestinalis in Iran.

Abstract

SUMMARY Nineteen cases of pneumatosis cystoides intestinalis all affecting adults and all involving the small intestine have been collected in two centres of Iran (Shiraz and Tehran) over a 20 year period, the pathological findings being divided into three groups: pure submucosal, combined submucosal and subserosal, and pure subserosal cysts. Experimental PCI was produced in cadavers using high pressure oxygen insuflation of the lungs, thus lending support to the theory that it has a mechanical origin. Othet theories of aetiology include tumour, nutritional deficiencies, gasforming organisms, alveolar rupture, and acid-base disturbance. In most of the cases presented high intraluminal pressure produced by obstruction appeared to force intraluminal gas through a breach in the mucosa into either the lymphatics or perivascular tissue to produce PCI. It is concluded that the aetiology in the vast majority of adult cases is mechanical in nature and that bacteria seem to play very little part, unlike their role in the PCI of infants.Pneumatosis cystoides intestinalis (PCI) is a condition in which air is found, characteristically, in encysted form in any part of the gastrointestinal tract. However, although it is a rare disease, a steady stream of reports on it have been appearing in the literature since Du Vernoi (1783) first noticed the condition and Bang (1876) who reportedly gave a complete description of the first case observed in human necropsy. The extensive review by MacKenzie (1951), Koss in 1952, Romeo (1967, and the more recent review by Ecker et al. (1971) and the experience of the Mayo Clinic, reported by Shallal et al. (1974), give an idea of the accumulated world experience of this condition. As far as the aetiology of this 'disease' is concerned the reader should refer to the works of Finney

Neumatosis cystoides intestinalis

“…Con pocas excepciones predomina el sexo masculino (ro• zón por sexo m:f= l, 9-3,5: 1) ( 17, 33,30). Por edad, el máximo de casos se encuentran entre los 30 y 60 años (10, 18, 30, 33, 39 46) con preferencia de la sexta década en mujeres y tercera a quinta en los hombres (30,43).…”

“…153 a lo largo de los vasos del retroperitoneo ( 14). Se ha comprobado mediante ensayos en cadáveres esta formación de una neumatosis subserosa (43). Sorprende que a pesar de todos estos ensayos en la bibliografía relacionada con la teoría pulmonar no hay ninguna cita en la cual se haya puesto en evidencia la presencia de aire en el mediastino (47).…”