Bailey Jennifer, Shaffer Eldon A
Division of Gastroenterology, Faculty of Medicine, University of Calgary, Teaching Research & Wellness Building, Room 6D48, 3280 Hospital Dr NW, Calgary, AB, Canada T2N4N1.
Case Rep Med. 2010;2010:138369. doi: 10.1155/2010/138369. Epub 2010 Nov 11.
Pneumatosis intestinalis is a rare disorder characterized by gas-filled cysts within the subserosal and/or submucosal regions of the intestinal wall. The source of this gas and its translocation across the mucosa is incompletely understood. Most (85%) cases are associated with medical conditions, ranging from psychiatric through respiratory disorders to gastrointestinal-related diseases; the remaining 15% lack any recognizable cause or association. In this case report, pneumatosis coli (affecting the colon) occurred in a patient following abdominal surgery and was associated with pseudomembranous colitis, which was Clostridium difficile toxin negative-presumably a false negative. Supportive care and appropriate antibacterial agents sufficed to alleviate symptoms and resolve the pneumatosis. Recognizing this uncommon but important association can avoid high financial and personal costs from unnecessary testing and invasive surgical explorations. Consideration should be given to pseudomembranous colitis as the basis for pneumatosis coli developing in patients who have received antibiotics, once gut ischemia has been ruled out.
肠壁积气是一种罕见的病症，其特征是肠壁浆膜下和/或黏膜下层区域出现充满气体的囊肿。这种气体的来源及其穿过黏膜的转移过程尚不完全清楚。大多数（85%）病例与多种疾病相关，范围从精神疾病到呼吸系统疾病再到胃肠道相关疾病；其余15%没有任何可识别的病因或关联。在本病例报告中，一名患者腹部手术后发生结肠积气（累及结肠），并与假膜性结肠炎相关，该假膜性结肠炎艰难梭菌毒素检测为阴性——可能是假阴性。支持性护理和适当的抗菌药物足以缓解症状并消除肠壁积气。认识到这种不常见但重要的关联可以避免因不必要的检查和侵入性手术探查而产生的高昂经济和个人代价。对于接受过抗生素治疗且已排除肠道缺血的患者，应考虑假膜性结肠炎是结肠积气发生的基础。
