Pneumatosis cystoides intestinalis revealed by an occlusive syndrome: A case report

Abstract

Introduction: Pneumatosis cystoides intestinalis is a rare condition characterized by the presence of gas cysts in the intestinal wall. It can affect different segments of the digestive tract. Male patients over 50 years old seem to be more affected. Classically, one opposes the primary or idiopathic forms and the secondary forms. Case Report: We report the case of a 62-year-old female patient with a history of treated peptic ulcers, who presented with episodes of intermittent atypical abdominal pain that worsened abruptly. The physical examination revealed a surgical abdomen with tenderness to palpation. The patient underwent a jejunal resection. The pathological examination showed macroscopically an intestinal fragment with confluent subserosal and intestinal intraparietal bullae. On opening, the portion containing the bullae was thickened, infarcted, congestive, hemorrhagic, and brittle with narrowing of the intestinal lumen. The bullae are tense and leave serosities. On histological examination, the intestinal wall was very congestive with hemorrhagic patches of suffusion. There were optically empty cystic formations that does not communicate with the digestive lumen. The adjacent mucosa is the site of a moderate subacute inflammatory reaction. Conclusion: Pneumatosis cystoides intestinalis is a rare and usually benign pathology. The symptoms, when they exist, are not specific. Its physiopathology is still very much debated. The prognosis is generally good. The knowledge of this pathology is necessary to avoid invasive explorations and heavy treatment without interest for the patient.