Slesser A A P, Patel P H, Das S C, Leahy A, Livingstone J, Riaz A A
Department of General Surgery, Watford General Hospital, Vicarage Road, Watford, UK.
Int J Surg Case Rep. 2011;2(7):185-7. doi: 10.1016/j.ijscr.2011.06.003. Epub 2011 Jul 12.
Pneumatosis intestinalis is a rare condition affecting 0.03% of the population. It has a myriad of aetiological causes and hence presentation can vary immensely. The management of symptomatic pneumatosis intestinalis in an acute and outpatient setting remains a challenge to both physicians and surgeons.
We present a case of a 79 year old who presented in a gastroenterology outpatients department with a history suggestive of intermittent small bowel obstruction associated with abdominal pain aggravated by eating and posture. He was found to have signs suggestive of Marfan's syndrome. Computed tomography demonstrated extensive pneumatosis intestinalis of the small bowel. Due to deterioration in symptoms, an exploratory laparotomy was performed demonstrating segmental small bowel pneumatosis intestinalis secondary to a hypermobile mesentery.
This case highlights the importance of both surgical and gastroenterology expertise in successfully managing symptomatic pneumatosis intestinalis.
肠壁囊样积气症是一种罕见疾病，影响人群的比例为0.03%。其病因众多，因此临床表现差异极大。在急性和门诊环境中，对有症状的肠壁囊样积气症进行管理，对内科医生和外科医生来说仍是一项挑战。
我们报告一例79岁患者，该患者就诊于胃肠病门诊，病史提示间歇性小肠梗阻，进食和改变姿势会加重腹痛。检查发现其体征提示患有马凡氏综合征。计算机断层扫描显示小肠广泛存在肠壁囊样积气症。由于症状恶化，遂进行剖腹探查，结果显示为活动度过大的肠系膜继发节段性小肠肠壁囊样积气症。
该病例凸显了外科和胃肠病学专业知识在成功管理有症状的肠壁囊样积气症方面的重要性。
