Mehmood Asif, Essrani Rajesh, Parvataneni Swetha, Iqbal Umair
Internal Medicine, Geisinger Medical Center, Danville, USA.
Internal Medicine, Abington Hospital - Jefferson Health, Abington, USA.
Cureus. 2020 Jun 22;12(6):e8765. doi: 10.7759/cureus.8765.
Pneumatosis intestinalis (PI) consists of multiple, thin, gas-filled cysts in the wall of the gastrointestinal (GI) tract. It is an uncommon entity that can involve any gastrointestinal site from the stomach to the rectum. Isolated stomach involvement is rare. PI can represent a broad spectrum of diseases with variable prognoses. We present the case of a patient who was admitted with gastroenteritis-like symptoms. He remained hemodynamically stable, and on further imaging with contrast-enhanced computed tomography of the abdomen and pelvis, air was found in the portal vein and gastric wall, with minimal thickening of the proximal small bowel concerning for emphysematous gastroenteritis. Further workup results were negative, including blood cultures, stool studies, Clostridium difficile toxins, and lactic acid levels. The patient was managed nonoperatively and recovered without serious complications. Our case is unique in terms of the presence of air in the portal vein, which would otherwise suggest the possible spread of infection across the bowel wall.
肠壁积气（PI）表现为胃肠道（GI）壁内多个薄的、充满气体的囊肿。它是一种罕见的病症，可累及从胃到直肠的任何胃肠道部位。孤立的胃部受累很少见。PI可代表一系列预后各异的疾病。我们报告一例表现为类似肠胃炎症状入院的患者。他血流动力学保持稳定，在进一步行腹部和盆腔增强计算机断层扫描成像时，发现门静脉和胃壁内有气体，近端小肠轻度增厚，考虑为气肿性肠胃炎。包括血培养、粪便检查、艰难梭菌毒素和乳酸水平在内的进一步检查结果均为阴性。该患者接受非手术治疗，康复且未出现严重并发症。我们的病例在门静脉内存在气体方面具有独特性，否则这可能提示感染可能已穿过肠壁扩散。
