Pneumatosis cystoids intestinalis in a patient with small bowel obstruction: a case report

Abstract

Pneumatosis cystoides intestinalis is a rare and usually benign condition in which multiple thin-walled cysts develop in the submucosa or subserosa of the gastrointestinal tract. While usually asymptomatic, severe cases can result in pneumoperitoneum, which can be managed surgically or medically depending on circumstances. A 35-year-old male patient presented with signs and symptoms of intestinal obstruction. Then the patient was diagnosed with pneumatosis cystoides intestinalis. The patient underwent surgery, and antibiotic treatment, and was discharged improved with no incident. Pneumatosis cystoides intestinalis is a surgical condition that resembles other life-threatening top surgical emergencies and affects clinicians' decisions on diagnosis and treatment plans substantially, mainly in low-income countries. So, surgeons have to consider such kind of conditions and avoid the costs and morbidities associated with unnecessary bowel resection or surgery.

Keywords: Eastern Ethiopia; a case report; pneumatosis cystoids intestinalis; small bowel obstruction; surgery.

Figure 1

Abdominal X-ray showing dilated small with significant multiple air-fluid levels.

Figure 2

Intra-operative finding shows anticlockwise volvulated small bowel.

Figure 3

Intra-operative finding shows multiple air-filled cysts in the small bowel.

Figure 4

Microscopic examination shows variable-sized cystic spaces lined by thin fibrous stroma with focal multinucleated macrophages surrounding the space and intervening fibrous stroma with congested blood vessels and neutrophil mixed inflammatory cells.