Koysombat Kanyada, Capanna Maria Vittoria, Stafford Nina, Orchard Tim
Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK.
BMJ Case Rep. 2018 Jul 11;2018:bcr-2018-225068. doi: 10.1136/bcr-2018-225068.
We present a case of a patient with pneumatosis intestinalis and pneumoperitoneum secondary to gastrointestinal systemic sclerosis, who presented following recurrent accident and emergency attendances with abdominal pain. Pneumatosis intestinalis is a rare complication of systemic sclerosis; management approaches focus largely on exclusion of life-threatening surgical pathologies and subsequent symptom control. To date, there are still no established gold-standard treatment strategy and no large-scale trial data to support a specific management strategy. We describe a case of successful medical management with a combination of antimicrobial, elemental diet and high-flow inhalation oxygen therapy, with supporting evidence of CT image confirming resolution. This case therefore contributes to the literature, being the first to report both symptomatic and radiological improvement following combination therapy without the need for surgical intervention.
我们报告一例因胃肠道系统性硬化症继发肠壁积气和腹腔积气的患者，该患者因反复出现腹痛而多次到急诊就诊。肠壁积气是系统性硬化症的一种罕见并发症；管理方法主要集中在排除危及生命的外科病变以及随后的症状控制上。迄今为止，仍没有既定的金标准治疗策略，也没有大规模试验数据支持特定的管理策略。我们描述了一例通过抗菌药物、要素饮食和高流量吸氧疗法联合成功进行药物治疗的病例，CT图像的支持证据证实了病情缓解。因此，该病例为文献提供了资料，是首例报道联合治疗后症状和影像学均有改善且无需手术干预的病例。
