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Case of Acute abdomen with gastric volvulus due to pneumatosis cystoides intestinalis: A report

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-07-19T00:45:31+05:30  |  Updated On 19 July 2022 12:45 AM IST
Case of Acute abdomen with gastric volvulus due to pneumatosis cystoides intestinalis:  A report
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Researchers have reported a rare case of Acute abdomen with gastric volvulus due to pneumatosis cystoides intestinalis that has been published in published in BMC Surgery.

Pneumatosis intestinalis is the abnormal presence of free air in many forms outside the lumen of the intestines. Classified as primary or secondary according to its etiology, it affects infants as well as adults and can affect any part of the GI tract.

Pneumatosis intestinalis can be classified as primary or secondary, but both represent the underlying pathology. The pathophysiology and etiology depend on the underlying conditions and prompt diagnosis is crucial in determining the treatment regimen. This activity reviews the evaluation and management of pneumatosis intestinalis and highlights the importance of an interprofessional team in the management of patients with this condition.

Researchers report a 55-year-old male patient with a past medical history of surgically repaired perforated duodenal ulcer, presenting with acute abdominal pain, bloating, and constipation. In the abdominal examination; Severe distention, tenderness and tympanicity were recorded on percussion. An erect CXR was performed and showed bilateral subdiaphragmatic air levels. We performed an abdominal Paracentesis which caused a large volume of air to be evacuated below the right subcostal margin. Subsequently, an exploratory laparotomy showed that the cause was a gastric volvulus associated with anterior and posterior gastric wall ruptures. Appropriate surgical repair approach was applied, but another lesion was detected incidentally. A pneumatosis cystoides intestinalis (PCI) has spread along the great length of the intestines in many forms and without any symptoms or signs.

Thus, the researchers concluded that pneumatosis cystoides intestinalis has usually been reported in relation to peptic ulcer disease (PUD). In the instant case they have reported a new association of gastric volvulus and pneumatosis cystoides intestinalis secondary to pyloric stenosis caused by duodenal ulcer; They believe it can help diagnose dangerous complications of a rare disease.

Reference:

Chihab, M., Qadabashi, K., Abbas, H. et al. Acute abdomen with gastric volvulus revealing an underlying pneumatosis cystoides intestinalis: a case report. BMC Surg 22, 267 (2022). https://doi.org/10.1186/s12893-022-01717-6

BMC SurgeryPneumatosis cystoides intestinalispeptic ulcer disease
Source : BMC Surgery
Dr. Shravani Dali
Dr. Shravani Dali

    Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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