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Rapid reversal of colonic pneumatosis with restoration of mesenteric arterial supply

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Abstract

Pneumatosis cystoides intestinalis (PCI) is characterized by gas-filled cystic lesions within the wall of the large intestine and presents along a spectrum of clinical severity ranging from benign to life threatening. Etiopathogenesis is multifactorial and postulated to result from either mechanical or bacterial causes. In this report, we present a patient with chronic abdominal pain evaluated with colonoscopy revealing segmental PCI isolated to the distal colon. Further investigation revealed an abdominal aortic aneurysm (AAA) compromising the inferior mesenteric artery takeoff. Endovascular repair of the AAA resulted in clinical resolution of abdominal pain and endoscopic resolution of PCI. To our knowledge, this is the first report to document endoscopic resolution of PCI with restoration of mesenteric arterial supply, highlighting vascular insufficiency as a predisposing and reversible pathogenic mechanism.

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References

  1. Pieterse AS, Leong AS, Rowland R. The mucosal changes and pathogenesis of pneumatosis cystoides intestinalis. Hum Pathol. 1985;16:683.

    Article  CAS  Google Scholar 

  2. Morris MS, Gee AC, Cho SD, et al. Management and outcome of pneumatosis intestinalis. Am J Surg. 2008;195:679–82.

    Article  Google Scholar 

  3. Varano VJ, Bonanno CA. Colonoscopic findings in Pneumatosis cystoides intestinalis. Am J Gastroenterol. 1973;59:353–60.

    CAS  PubMed  Google Scholar 

  4. Rachapalli V, Chaluvashetty SB. Pneumatosis cystoides intestinalis. J Clin Diagn Res. 2017;11:TJ01–TJ02.

    PubMed  PubMed Central  Google Scholar 

  5. Gillon J, Logan RF, Sircus W, et al. Symptomatic treatment of primary pneumatosis coli with metronidazole. Br Med J. 1980;280:1087.

    Article  CAS  Google Scholar 

  6. Masterson JS, Fratkin LB, Osler TR, et al. Treatment of pneumatosis cystoides intestinalis with hyperbaric oxygen. Ann Surg. 1978;187:245–7.

    Article  CAS  Google Scholar 

  7. van der Linden W, Marsell R. Pneumatosis cystoides coli associated with high H2 excretion. Treatment with an elemental diet. Scand J Gastroenterol. 1979;14:173–4.

    Article  Google Scholar 

  8. Rathi C, Pipaliya N, Poddar P, et al. A rare case of hypermobile mesentery with segmental small bowel pneumatosis cystoides intestinalis. Intest Res. 2015;13:346–9.

    Article  Google Scholar 

  9. St Peter SD, Abbas MA, Kelly KA. The spectrum of pneumatosis intestinalis. Arch Surg. 2003;138:68–75.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Gastroenterology, Banner University Medical Center, Phoenix, AZ, USA

    Hussein Abidali

  2. Internal Medicine, Banner University Medical Center, University of Arizona College of Medicine-Phoenix, 1111 E McDowell Rd, Phoenix, AZ, 85006, USA

    Lauren Cole

  3. Banner Transplant and Advanced Liver Disease Center, Phoenix, AZ, USA

    Anil Bellur Seetharam

  4. University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Anil Bellur Seetharam

Authors
  1. Hussein Abidali
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  2. Lauren Cole
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  3. Anil Bellur Seetharam
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Corresponding author

Correspondence to Lauren Cole.

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The authors declare that they have no conflict of interest.

Human/animal rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Abidali, H., Cole, L. & Seetharam, A.B. Rapid reversal of colonic pneumatosis with restoration of mesenteric arterial supply. Clin J Gastroenterol 11, 461–464 (2018). https://doi.org/10.1007/s12328-018-0872-2

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  • DOI: https://doi.org/10.1007/s12328-018-0872-2

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