Pneumatosis intestinalis presenting as pneumoperitoneum in a teenage girl with pyloric stenosis

Wong, Charlotte; Chung, Patrick Ho Yu; Wong, Kenneth K. Y.; Tam, Paul Kwong‐Hang

doi:10.1136/bcr-2014-208496

Cited by 4 publications

(4 citation statements)

References 13 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The pathogenesis of PCI is still uncertain, and there are 4 main theories that could explain its origin: 1) bacterial -the presence of gas-producing bacteria inside the intestinal wall; 2) mechanical -increased intraluminal pressure or epithelial injury allowing gas passage from the lumen into the intestinal wall; 3) biochemical -increased hydrogen gas production from carbohydrate fermentation exerts pressure within the intestinal lumen and is forced through the mucosa; 4) pulmonary diseases such as COPD and interstitial pneumonia may cause alveolar rupture leading to gas release, which travels along the mesenteric vessels into the mesentery. Coughing with abrupt changes in intra-abdominal pressure may also be an important contributing factor 2,3,5,7,9,[11][12][13]15,[19][20][21]26,[28][29][30] .…”

Section: Discussionmentioning

confidence: 99%

“…It has a worldwide incidence of 0.03% and is more common in men, with a 3:1 male-to-female ratio [1][2][3][4][5][6][7][8][9][10] . It was first described by DuVernoi et al in 1783, and its etiology and pathogenesis still remain unclear 2,7,8,[11][12][13][14][15][16] . Pneumoperitoneum may also be observed and is secondary to subserosal bleb rupture 17 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

Piltcher-da-Silva¹,

Sasaki²,

Gallotti³

et al. 2022

CBR

View full text Add to dashboard Cite

Introduction: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by gas-filled cysts in the intestinal wall. Although rare, it may also involve other regions, such as the mesentery. PCI is classified as primary or secondary and is associated with multiple predisposing factors. It may be associated with either a benign condition or a potentially fatal condition, such as mesenteric ischemia. The objective of this study was to review the medical literature on the rare benign presentations of PCI, excluding cases associated with intestinal ischemia. Methods:We conducted a systematic literature review according to the PRISMA statement. We searched PubMed and LILACS databases for articles published between January 2015 and December 2020 using the following Medical Subject Headings: "pneumatosis cystoides intestinalis" and "pneumoperitoneum," "pneumatosis intestinalis," and "pneumoperitoneum" or "mesenteric pneumatosis." Results:We included 51 articles comprising 58 patients with PCI and pneumoperitoneum. Most patients were men, and mean patient age was 64.9 years. We identified an idiopathic etiology in 29.31% of cases, and the most common predisposing factor was immune dysfunction (29.31%). A total of 24.13% of patients were asymptomatic. The most commons symptoms were abdominal pain (43.10%), nausea and vomiting (41.37%), and abdominal distention (37.93%). Diagnostic surgery was conducted in 26 patients (44.82%). Only 1 patient underwent surgical treatment.Conclusions: PCI is a clinical condition that may have a benign etiology and not require surgery. Treatment of the benign etiology is conservative. Thus, life-threatening conditions should be excluded in all cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

Piltcher-da-Silva¹,

Sasaki²,

Gallotti³

et al. 2022

CBR

View full text Add to dashboard Cite

show abstract

“…PCI can be divided into primary (15%) and secondary (85%) types [5]. Various gastrointestinal and non-gastrointestinal diseases has been considered as causes of secondary types of PCI, such as bowel ischemia [6], inflammatory bowel diseases, bowel infection, gastroduodenal ulcer, necrotizing enterocolitis [5], pyloric stenosis [7], diverticular disease [5], obstructive pulmonary disease [8], drugs (e.g., alpha-glucosidase inhibitors) [9,10], collagen tissue diseases [11,12], acquired immune deficiency syndrome [13] and malnutrition [4,5,14]. Anywhere none of these symptoms and diseases affected our patient, so his type of PCI can be cosidered as primary type.…”

Section: Discussionmentioning

confidence: 99%

An asymptomatic case of pneumatosis cystoids intestinalis: A case report

Loiodice¹,

Montenegro²,

Loiacono³

et al. 2021

Case Rep Imag Surg

View full text Add to dashboard Cite

Introduction: pneumatosis cystoides intestinalis is an uncommon disease characterized by the presence of gas within the submucosa or subserosa of the intestine. Pneumatosis cystoides intestinalis can be often localized in colon and it may be asymptomatic.Case presentation: A 53's man, with an autistic spectrum disorder and no other comorbidities nor symptoms, underwent a colonoscopy because of finding of a wall thickening of the rectum on the last abdominal computerized tomography. The colonoscopy revealed the presence of multiple cysts, resembling a bunch of grapes at the left-colonic flexure with normal overlying mucosa. Conclusion:pneumatosis cystoides intestinalis may be asymptomatic or sometimes diagnosed incidentally during colonoscopy. The treatment approach depends on underlying cause and it can be conservative or surgical in restricted cases.

show abstract

“…In a recent Hong Kong study, Wong et al . reported on a 16‐year‐old patient with pyloric stenosis who developed PCI and spontaneous pneumoperitoneum after oesophagogastroduodenoscopy and balloon dilatation . The authors postulated that the mechanical theory of high pressure from the jet of air through the stenotic pylorus and mucosal trauma from the guidewire contributed to the pneumatosis.…”

Section: Discussionmentioning

confidence: 99%

A case of pneumatosis cystoides intestinalis in connective tissue disease

Fung

Tsui

et al. 2016

Surgical Practice

View full text Add to dashboard Cite

Pneumatosis cystoides intestinalis (PCI) with spontaneous pneumoperitoneum is a rare but important condition in patients with connective tissue disease. In the present study, we report on a woman with mixed connective tissue disease who presented with PCI, and subsequently symptoms, of chronic intestinal pseudoobstruction. Prompt surgical resection of the bowel segment with pneumatosis should be considered to prevent a condition of gas leakage from turning into full-blown chemical peritonitis.

show abstract

Pneumatosis intestinalis presenting as pneumoperitoneum in a teenage girl with pyloric stenosis

Abstract: A 16-year-old girl presented with free gas under the diaphragm after endoscopic balloon dilation for pyloric stenosis. There was no perforation site identified on laparotomy. However, there was massive pneumatosis intestinalis involving the entire small bowel.

Cited by 4 publications

References 13 publications

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

Management of pneumatosis cystoides intestinalis with pneumoperitoneum: 5-years systematic review

An asymptomatic case of pneumatosis cystoids intestinalis: A case report

A case of pneumatosis cystoides intestinalis in connective tissue disease

Contact Info

Product

Resources

About