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Revista colombiana de Gastroenterología
versión impresa ISSN 0120-9957versión On-line ISSN 2500-7440
Resumen
BLANCO-AVELLANEDA, Camilo de Jesús y PRIETO-ORTIZ, Robin Germán. Pneumatosis Cystoides Intestinalis with Non-surgical Encapsulated Pneumoperitoneum: Case Presentation and Literature Review. Rev. colomb. Gastroenterol. [online]. 2023, vol.38, n.1, pp.111-116. Epub 08-Jun-2023. ISSN 0120-9957. https://doi.org/10.22516/25007440.908.
Introduction:
Pneumatosis cystoides intestinalis (PCI) is a rare entity characterized by cysts or air bubbles in the intestinal wall, usually asymptomatic. Its uncomplicated forms are managed conservatively, and the severe ones require surgical intervention. The presence of pneumoperitoneum is a disturbing radiological finding but not an indicator of surgical intervention.
Clinical case:
A 23-year-old man presented with weight loss, diarrhea, and rectal bleeding; a colonoscopy showed multiple violaceous cysts in the sigmoid and descending colon that collapsed after puncture and biopsies. Computed tomography (CT) confirmed the diagnosis and the presence of an encapsulated pneumoperitoneum. The absence of signs of potential lethality allowed conservative treatment with clinical remission during the first eight months of follow-up.
Discussion:
The pathophysiology of PCI is not well defined. Our patient’s diagnosis was incidental when performing a colonoscopy for rectal bleeding. Asymptomatic encapsulated pneumoperitoneum should be interpreted as an important but not decisive sign of surgical intervention. Its presence, along with the medical history and physical, biochemical, endoscopic, and imaging examination, can prevent unnecessary surgery.
Palabras clave : Pneumatosis cystoides intestinalis; pneumoperitoneum; large intestine; colonoscopy; observation.