Pneumatosis Intestinalis After Colonoscopy in a Crohn’s Disease Patient with Mucosal Healing

Fu, Nancy; Kim, Edward; Bressler, Brian

doi:10.1002/ibd.22840

Cited by 14 publications

(4 citation statements)

References 7 publications

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“…La teoría mecánica que se explica a partir del aumento de la presión intraluminal producido por diversas causas (tumores, isquemia, cirugía, etc. ), produce una injuria de la pared intestinal y la migración de gas a través de ella [8,9] . La teoría pulmonar afirma que en condiciones como la enfermedad pulmonar obstructiva crónica (EPOC), asma, neumonía, etc., se produce un neumomediastino que favorece el pasaje de gas a través de la aorta y desde esta al mesenterio y el tejido intestinal [1,10] .…”

Section: Discussionunclassified

Caso clínico: pneumatosis intestinal

Cecenarro

Gómez

Gramática

2018

Rev Fac Cien Med Univ Nac Cordoba

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<div class="WordSection1">Objetivo: presentar un caso clínico reciente para aumentar el entendimiento, diagnóstico y tratamiento de la neumatosis intestinal, considerar las características distintivas de la enfermedad y así poder ampliar los conocimientos acerca del manejo de esta patología.Métodos: se presenta el caso de una paciente femenina de 65 años, originaria de Bolivia, con historial de artrosis, osteoporosis, asma y alergias a repetición. La paciente ingresa al Servicio de Cirugía N° 1 del HNC, en el mes de noviembre del 2015, con un cuadro clínico poco claro. En el transcurso de la internación se descubre la presencia de burbujas aéreas en la mucosa del colon y una lesión tumoral en duodeno. Rápidamente se comienza con el tratamiento y soporte adecuado para su estabilización. Se plantea una búsqueda bibliográfica y una puesta al día de las últimas actualizaciones en relación a esta patología. Se utilizaron buscadores médicos de renombre como PUBMED, UP TO DATE, VBS. Se seleccionaron una serie de artículos al respecto.La paciente citada en este trabajo ha otorgado el correspondiente consentimiento por escrito para la publicación anónima y con fines científicos de su infomación.Declaramos además la ausencia de financiamiento externo y conflictos de interés alguno.Conclusiones: se pudo concluir que el manejo en general debe ser conservador, excluyendo el caso de las complicaciones (oclusión, perforación) y a la sospecha de isquemia intestinal. La laparoscopía exploradora puede ser de ayuda para determinar la conducta apropiada. El tratamiento conservador incluye antibióticos, oxígeno hiperbárico y medidas de sostén.</div>

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Section: Discussionunclassified

Caso clínico: pneumatosis intestinal

Cecenarro

Gómez

Gramática

2018

Rev Fac Cien Med Univ Nac Cordoba

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“…First, mechanical, through either an increased intraluminal pressure forcing gas into the gut wall (eg, intestinal obstruction)14 or intestinal wall injury allowing air to leak into the bowel wall (eg, inflammatory bowel conditions and bowel ischaemia) 15. Second, through bacterial invasion into the bowel wall, leading to gas production within the wall of the gut itself,8 16 this theory is supported by the successful treatment of PI with antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Management of pneumatosis intestinalis in children over the age of 6 months: a conservative approach

et al. 2017

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“…For example, “the mechanical theory” means that intestinal obstruction, inflammatory bowel disease, ischemic bowel disease, gastroenteric tumor, anorectal surgery, and bowel preparation or colonoscopy resulting in intestinal wall injury or increased intraluminal pressure serve as the causative agent in PCI of intramural gas. [ 24 , 25 ] Meanwhile, the bacterial theory refers to the production of gas by gas-forming bacteria that enters the mucosal barrier through mucosal rents or increased mucosal permeability. Indirect support for this theory was obtained by the successful treatment of PCI with antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal malignant neoplasms disguised as pneumatosis cystoids intestinalis

2017

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Rationale:Pneumatosis cystoids intestinalis (PCI) is a rare disease in which gas develops in the mucosa or submucosa of the digestive tract. The etiology and pathogenesis of this disease, at present, remain unclear, and gastrointestinal malignant neoplasms may be a potentially important cause. Herein, we report a case of mantle cell lymphoma presenting as PCI as well as present a literature review of cases of suspect PCI that was definitively diagnosed as gastrointestinal neoplasms. In doing so, we highlighted cases of neoplastic pathogenesis that present as PCI.Patient concerns:A 55-year-old man was referred to our gastrointestinal department with complaints of intermittent abdominal pain, distention, diarrhea, and occasional melena that persisted for 2 months. He has a history of nasopharyngeal carcinoma.Diagnoses:Intensive, translucent, grape-like cystoids of the whole colon and small intestine were disguised as PCI upon colonoscopy and capsule endoscopy.Interventions:Right hemicolectomy and ileocecectomy were performed for intussusception and to confirm the diagnosis. Final pathology indicated that the mass was mantle cell lymphoma.Outcomes:After surgery and subsequent chemotherapy, the patient showed good recovery and no abnormal lesions were detected on colonoscopy.Lessons:As shown through this case and a literature review of similar cases of apparent PCI that was definitively diagnosed as gastrointestinal neoplasm, gastrointestinal malignant neoplasms might rarely present as PCI and neoplastic etiologies should also be considered once PCI is detected. Because most patients with malignant PCIs might inevitably experience severe complications, abdominal surgery should be considered and applied timely after unsuccessful resolution by conservative medical therapies and symptomatic treatments.

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Pneumatosis Intestinalis After Colonoscopy in a Crohn’s Disease Patient with Mucosal Healing

Cited by 14 publications

References 7 publications

Caso clínico: pneumatosis intestinal

Caso clínico: pneumatosis intestinal

Management of pneumatosis intestinalis in children over the age of 6 months: a conservative approach

Gastrointestinal malignant neoplasms disguised as pneumatosis cystoids intestinalis

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