Andresen S J, Grønneberg K G, Oppedal T
Kirurgisk avdeling, Rjukan sykehus.
Tidsskr Nor Laegeforen. 1999 May 10;119(12):1756-7.
Patients with free intraperitoneal air usually undergo emergency surgery. Some of these patients will have no identifiable perforation, for instance those with pneumatosis cystoides intestinalis. This is a rare condition characterized by multiple intramural gas cysts in the gastrointestinal tract. The most common symptoms are meteorism, excessive flatulence, diarrhoea, abdominal pain, passage of mucus per rectum, or rectal bleeding. A case of pneumatosis cystoides intestinalsis is described. Plain abdominal radiographs showed distended bowel with free intraperitoneal air and intramural gas collections. At laparotomy, multiple intramural cysts were found, but no perforation or obstruction. The symptoms resolved after laparotomy, and the patient was discharged after a few days. The aetiology and pathogenesis of pneumatosis cystoides intestinalis are unknown, although deficient hydrogen metabolism and gasforming bacteria that penetrate the mucosal barrier may be involved. If needed, hyperbaric oxygen therapy is the treatment of choice. Surgery is indicated only in fulminant cases.
腹腔内有游离气体的患者通常需要接受急诊手术。其中一些患者找不到明确的穿孔部位，比如患有肠壁囊样积气症的患者。这是一种罕见的病症，其特征是胃肠道内有多个壁内气体囊肿。最常见的症状是腹胀、屁多、腹泻、腹痛、直肠排黏液或直肠出血。本文描述了一例肠壁囊样积气症病例。腹部平片显示肠管扩张，伴有腹腔内游离气体和壁内气体积聚。剖腹探查时发现多个壁内囊肿，但未发现穿孔或梗阻。剖腹探查后症状缓解，患者几天后出院。尽管肠壁囊样积气症的病因和发病机制尚不清楚，但可能与氢代谢不足以及穿透黏膜屏障的产气细菌有关。如有必要，高压氧治疗是首选治疗方法。仅在暴发性病例中才需要进行手术。
