Saber Aly
Department of general surgery, Port-Fouad General Hospital, Al-obour street- Port-Fouad, 11361, Egypt.
Cases J. 2009 Apr 29;2:7079. doi: 10.1186/1757-1626-0002-0000007079.
Pneumatosis cystoides intestinalis is a rare disease characterized by presence of multilocular cysts in the gastrointestinal wall. Rarely, patients may experience symptoms secondary to the cysts. The pathogenesis of pneumatosis cystoides intestinalis is still unclear and many theories have been advocated to explain the exact origin. Complications occur in about 3% of cases and include obstruction, intussusception, volvulus, haemorrhage and intestinal perforation.
The author reported a male patient aged 56 years presented to the emergency department with acute upper abdominal pain. Widespread variable sized serosal intestinal air cysts were seen at the first look involving long segment of jejunum and ileum. Perforated duodenal ulcer, as the cause of generalized peritonitis, was repaired with direct closure and omental patch. A second laparotomy, was done and exploration was systematically performed and denoted hugely distended stomach with cicatrisation at the site of previous closure of perforated duodenal ulcer and the whole length of small gut was completely free from the already described pneumatosis cystoides intestinalis.
The pneumatosis cystoides intestinalis is a rare disease and suspicion of this disease process should be based on imaging and clinical finding. The therapy can be conservative or surgical in restricted situations.
肠气囊肿症是一种罕见疾病,其特征为胃肠道壁内存在多房性囊肿。患者很少会因囊肿出现继发性症状。肠气囊肿症的发病机制仍不清楚,人们提出了许多理论来解释其确切起源。约3%的病例会出现并发症,包括梗阻、肠套叠、肠扭转、出血和肠穿孔。
作者报告了一名56岁男性患者,因急性上腹部疼痛就诊于急诊科。初诊时可见广泛大小不一的浆膜下肠气囊肿,累及空肠和回肠的长段。作为弥漫性腹膜炎病因的十二指肠溃疡穿孔,通过直接缝合和网膜修补进行了修复。进行了第二次剖腹手术,系统地进行了探查,发现胃极度扩张,十二指肠溃疡穿孔先前缝合部位有瘢痕形成,小肠全长完全没有上述肠气囊肿症。
肠气囊肿症是一种罕见疾病,对此病的怀疑应基于影像学和临床发现。在有限的情况下,治疗可以是保守的或手术的。