Tanabe Shunsuke, Shirakawa Yasuhiro, Takehara Yuko, Maeda Naoaki, Katsube Ryoichi, Ohara Toshiaki, Sakurama Kazufumi, Noma Kazuhiro, Fujiwara Toshiyoshi
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Acta Med Okayama. 2013;67(2):123-8. doi: 10.18926/AMO/49672.
An 80-year-old woman, who had been administered α-glucosidase inhibitor for diabetes, was brought to the hospital with the sensation of abdominal fullness and pain. Abdominal computed tomography indicated pneumatosis cystoides intestinalis (PCI) in the small intestinal wall, with free air within the abdomen. A blood examination showed no increases in white blood cells or C-reactive protein level. The patient's condition improved with conservative therapy. PCI with pneumoperitoneum induced by α-glucosidase inhibitor is rare, with only 27 cases (excluding the present case) reported in Japan to date. In PCI with pneumoperitoneum, differentiation from gastrointestinal perforation is important and following the clinical symptoms over time is vital.
一名80岁女性,因糖尿病一直服用α-葡萄糖苷酶抑制剂,因腹部饱胀感和疼痛入院。腹部计算机断层扫描显示小肠壁有肠壁囊样积气(PCI),腹腔内有游离气体。血液检查显示白细胞或C反应蛋白水平没有升高。患者经保守治疗后病情好转。由α-葡萄糖苷酶抑制剂引起的伴有气腹的PCI很少见,迄今为止日本仅报道了27例(不包括本病例)。在伴有气腹的PCI中,与胃肠道穿孔的鉴别很重要,密切观察临床症状的变化至关重要。