[Cystoid pneumatosis of the intestine. Apropos of 2 case reports]

Abstract

The authors report two cases of pneumatosis cystoides intestinalis involving the small intestine. The first patient, a 35-year-old man treated for duodenal ulcer since 1976, presented with digestive haemorrhage in 1981 for which a vagotomy and a gastroduodenoanastomosis were performed. He was seen in 1986 for a post-bulbar stenosis. On the plain abdomen radiography there were gaseous formations in the sub-phrenic region. At operation the post-bulbar stenosis was confirmed and a cystic pneumatosis interesting 60 cm of the ileum was present. A gastro-enteroanastomosis was performed with an ileal resection and reestablishment of the continuity. He had no recurrence of the disease. The second patient, a 77-year-old man, was admitted for a surgical treatment of a stenosing bulbar ulcer. On the chest X-ray there were many gaseous formations under the diaphragmatic cupula, characteristic of cystic pneumatosis. The surgical exploration confirmed pyloric stenosis for which a vagotomy and a gastroenteroanastomosis were practised; it was found a cystic pneumatosis interesting one meter of the small intestine, which was not resected. The postoperative course was uneventful. The authors review the literature about this benign disease, which can involve the small intestine in case of duodenal or pyloric stenosis. They stress the usefulness of plain radiography of abdomen demonstrating the presence of characteristic gaseous formations in the subphrenic region.