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Case Reports
. 2017 Sep 17;11(1):263.
doi: 10.1186/s13256-017-1421-1.

Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report

Kensuke Nakatani  1 , Takaharu Kato  2   3 , Shinichiro Okada  1 , Risa Matsumoto  1 , Kazuhiro Nishida  1 , Hiroyasu Komuro  1 , Toshiyuki Suganuma  1
Affiliations
Case Reports

Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report

Kensuke Nakatani et al. J Med Case Rep. .

Abstract

Background: Although gastrointestinal involvement in patients with granulomatosis with polyangiitis is uncommon, it is associated with mild to severe life-threatening complications. We present a case of pneumatosis cystoides intestinalis in a patient with granulomatosis with polyangiitis that was treated successfully with hyperbaric oxygen.

Case presentation: A 70-year-old Japanese man with a 3-year history of granulomatosis with polyangiitis consulted our hospital with a complaint of severe back pain. Computed tomography showed a large amount of gas located in his bowel wall and mesentery. He underwent urgent exploratory laparotomy, which led to a diagnosis of pneumatosis cystoides intestinalis without intestinal perforation or necrosis. He consequently underwent 13 sessions of hyperbaric oxygen therapy and was discharged from our hospital without complications.

Conclusions: Several previous reports have supported the efficacy of hyperbaric oxygen for treating pneumatosis cystoides intestinalis. The present case, however, is the first in which pneumatosis cystoides intestinalis in a patient with granulomatosis with polyangiitis was successfully treated with hyperbaric oxygen. We therefore suggest that hyperbaric oxygen therapy could be a candidate treatment for pneumatosis cystoides intestinalis in patients with granulomatosis with polyangiitis.

Keywords: Case report; Granulomatosis with polyangiitis; Hyperbaric oxygen therapy; Intestinal perforation; Pneumatosis cystoides intestinalis.

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Not applicable.

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Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Computed tomography shows a large amount of gas in the abdominal wall, bowel wall, and mesentery (arrows in axial view (a) and in coronal view (b)). It was difficult, however, to rule out the existence of free air in the abdominal cavity. Portomesenteric pneumatosis was not detected
Fig. 2
Fig. 2
Intraoperative exploratory laparotomy findings (Overall view (a)) revealed pneumatosis intestinalis without intestinal perforation or necrosis (arrows in (b))
Fig. 3
Fig. 3
The colonoscopy which was performed 2 years before the diagnosis of pneumatosis cystoides intestinalis showed multiple ulcers in his colon on the right side (arrows)
Fig. 4
Fig. 4
Computed tomography after hyperbaric oxygen treatment shows no gas located in the abdominal wall, bowel wall, or mesentery
See this image and copyright information in PMC

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