Ito Midori, Abe Masanori, Maruyama Takashi, Suzuki Hiroko, Inoshita Atsushi, Okada Kazuyoshi, Soma Masayoshi
Clin Nephrol. 2014 Nov;82(5):347-50. doi: 10.5414/CN107986.
Pneumatosis cystoides intestinalis is a condition in which polycystic air has entered the submucosa or serosa of the intestine. A 78-year-old man was admitted to our hospital for treatment of end-stage renal disease due to diabetic nephropathy. Peritoneal dialysis was initiated on hospital Day 14. We diagnosed peritonitis and the patient was treated with vancomycin on Day 40. However, computed tomography showed hepatic portal venous gas and dilation of the small intestine with pneumatosis on Day 55, and the patient subsequently died. Autopsy revealed multiple mucosal pneumatoses, up to 1 cm in diameter, from the duodenum to jejunum, which was consistent with pneumatosis cystoides intestinalis. No cystic lesions were found in the colon. Pneumatosis cystoides intestinalis is a rare and usually benign disorder, but in patients with diabetic end-stage renal disease, it may run a malignant course, perhaps due to uremic immune incompetence.
肠气囊肿症是一种多囊性气体进入肠黏膜下层或浆膜层的病症。一名78岁男性因糖尿病肾病导致的终末期肾病入住我院接受治疗。入院第14天开始进行腹膜透析。第40天我们诊断出腹膜炎，患者接受了万古霉素治疗。然而，在第55天计算机断层扫描显示肝门静脉积气以及小肠扩张并伴有气肿，患者随后死亡。尸检发现从十二指肠到空肠有多个直径达1厘米的黏膜下气肿，这与肠气囊肿症相符。结肠未发现囊性病变。肠气囊肿症是一种罕见且通常为良性的病症，但在糖尿病终末期肾病患者中，它可能会呈现恶性病程，这可能是由于尿毒症免疫功能不全所致。
