Ileal pneumatosis

Intestinal pneumatosis (IP) is a relatively rare, benign condition, described for the first time by Du Vernoi in 1730 [1]. It is characterized by the presence of gas inside the intestinal mucosa, and having an appearance of bunch-like cysts on endoscopy. Intestinal pneumatosis is usually asymptomatic, but may sometimes cause diarrhea, abdominal discomfort or pain, or constipation. Complications associated with intestinal pneumatosis, such as obstruction from volvulus or intussusception, are rare [2].

A 61-year-old woman was referred for our attention after developing abdominal pain. Blood examinations were negative. The patient underwent ileocolonoscopy, which showed the presence on the ileocecal valve of mucosal and confluent bunch-like cysts, with a thin and semitransparent wall ([Figure 1]). The same endoscopic signs were observed in the last 5 cm of the ileum. A study of the 20 cm of ileal mucosa that were proximal to the 5 cm cystic length was negative. The patient also underwent ultrasonography and a computed tomography abdominal scan but no other kind of lesion was found.

Figure 1 Ileal valve affected by pneumatosis.

Endoscopy_UCTN_Code_CCL_1AD_2AJ

References

• 1 Saito M, Tanikawa A, Nakasute K. et al . Additive contribution of a multiple factors in the development of pneumatosis intestinalis: a case report and review of the literature.  Clin Rheumatol. 2006;  11 1-3
• 2 St Peter S D, Abbas M A, Kelly K A. et al . The spectrum of pneumatosis intestinalis.  Arch Surg. 2003;  138 68-75