1/12. Pneumatosis [correction of pneumocystis] cystoides intestinalis with pneumoperitoneum and pneumoretroperitoneum in a patient with extensive chronic graft-versus-host disease.pneumatosis cystoides intestinalis is a rare finding of intramural gasfilled cysts in the bowel wall and sometimes free air in the abdomen. A few conditions are reported to cause this disease, one of them being immunosuppression. We describe a 50-year-old Caucasian male with extensive chronic graft-versus-host disease (GVHD) of the gut and skin who developed PCI with pneumoperitoneum and pneumoretroperitoneum. To our knowledge, this is the first report of PCI occurring in a patient with active chronic GVHD which resolved spontaneously.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
2/12. Acute abdomen and lupus enteritis: thrombocytopenia and pneumatosis intestinalis as indicators for surgery.Bowel symptoms occur often in systemic lupus erythematosus (SLE), but enteric complications in patients on steroid therapy are rare. We report a case of a 14-year-old Mexican girl with SLE on high-dose steroid therapy complicated by abdominal vasculitis and small bowel perforation. Accompanying this serious complication were thrombocytopenia and radiographic changes of pneumatosis intestinalis. These findings suggested necrotizing enteritis and prompted urgent surgery. Four jejunal perforations, pneumatosis intestinalis, and submucosal vasculitis were present in the resected specimen. Persistent SLE activity responded to cyclophosphamide, which is indicated in patients with digestive symptoms who fail to respond to high-dose steroids.- - - - - - - - - - ranking = 4keywords = abdomen (Clic here for more details about this article) |
3/12. Benign pneumatosis intestinalis coli after blunt trauma to the abdomen in a child.This report describes a 2 1/2-year-old boy who sustained blunt abdominal trauma and had pneumatosis intestinalis in the right colon. The child was successfully managed by observation. The pneumatosis resolved spontaneously.- - - - - - - - - - ranking = 4keywords = abdomen (Clic here for more details about this article) |
4/12. Pneumatosis of the bladder wall associated with necrotizing enterocolitis.Increasing use of sonography for imaging the abdomen of neonates has brought greater recognition of its value in diagnosing and monitoring complications of necrotizing enterocolitis. We describe a case in which pneumatosis of the bladder wall was visualized by sonography in a neonate with down syndrome and necrotizing enterocolitis.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
5/12. pneumatosis cystoides intestinalis with free intraperitoneal air: a case report.pneumatosis cystoides intestinalis (PCI) is a rare disorder of the medical management and clinical outcome of which largely depend on the severity of its clinical manifestation. A limited number of cases have been reported in the literature although it is suggested that the true incidence of this disorder is higher than observed in clinical practice. This is the case of a 76-year-old woman with a past medical history of Crohn's disease found to have PCI. The patient initially complained of abdominal pain, distention, and weight loss. Chest and abdominal radiographs demonstrated free intraperitoneal air. CT scans revealed characteristic air-filled cysts in the intestinal wall, which established the diagnosis of PCI. Because the patient did not have an acute abdomen or findings requiring emergency laparotomy she was treated nonoperatively with supportive care. Her symptoms resolved gradually over several days. The patient was discharged home in stable condition tolerating a regular diet and was doing well at follow-up. The sole finding of free air with PCI does not mandate exploratory laparotomy.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
6/12. pneumoperitoneum without perforation of the gastrointestinal tract.pneumoperitoneum (PP) is usually the result of perforation of the gastrointestinal (GI) tract with associated peritonitis. However, other rare causes, including spontaneous PP incidental to intrathoracic, intra-abdominal, gynecologic, and miscellaneous other origins not associated with a perforated GI tract have been described in the literature. Six cases of PP without any perforated GI tract are reported. Three patients with generalized peritonitis underwent exploratory laparotomy or laparoscopy when clinical examinations suggested an acute abdomen. At surgical procedure, perforated pyometra, perforated liver abscess and a ruptured necrotic lesion of a liver metastasis were documented in these patients, respectively. We also saw 3 PP patients not associated with peritonitis. Two patients with PP caused by pneumatosis cystoides intestinalis were encountered, 1 was managed conservatively and the other received diagnostic laparoscopy. A patient in whom pneumomediastinum and pneumoretroperitoneum were accompanied by PP caused by an alveolar rupture based on decreased pulmonary compliance due to malnutrition was managed conservatively. The history of the patient and knowledge of the less frequent causes of PP can possibly contribute towards refraining from exploratory laparotomy in the absence of peritonitis.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
7/12. Hepatic portal venous gas.BACKGROUND: Hepatic portal venous gas is an unusual entity associated with a variety of abdominal catastrophes. There is usually a grave prognosis when hepatic portal venous gas is associated with ischemic bowel disease. We reported a 57-year-old man with hepatic portal venous gas associated with extensive infarction of the jejunum and a concomitant perforation at a site in the terminal ileum leading to two operations performed 24 hours apart. Progressive ischemia and infarction after the initial laparotomy resulted in massive resection of the small bowel. methods: A follow-up abdominal radiography showed progressive dilatation of the small intestine and thickening of the bowel wall. Computed tomography of the abdomen showed pneumatosis intestinalis and gas collection within the intrahepatic and extrahepatic portal vein and superior mesenteric vein and free gas in the peritoneal cavity. RESULTS: At surgery, a long segment of ischemic change of the jejunum with focal necrosis and one perforation in the terminal ileum with no relation to the ischemic area was discovered. These two areas were resected respectively, and anastomosis was performed. Extensive necrosis of the residual bowel was found on the second-look operation performed 24 hours later, and subsequent resection of involved bowel was performed, resulting in a short-bowel condition. CONCLUSIONS: When hepatic portal venous gas associated with ischemic bowel disease is encountered, coexistence of other abdominal condition with no relation to ischemic segment should be considered.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
8/12. Innocuous pneumatosis intestinalis of the right colon in renal transplant recipients. Report of three cases.Three cases of innocuous pneumatosis intestinalis (IPI) of the right colon occurred in a series of 218 renal transplant recipients over a five-year period. Each of the three transplants was in the right iliac fossa. Clinically, these patients had little or no gastrointestinal symptoms and had normal physical examinations of the abdomen. One of the patients had a generalized herpes simplex type 2 (HSV II) infection. Cystic or linear lucencies were present within the bowel wall, associated with varying degrees of localized colonic distention. The condition (IPI) did not warrant surgical intervention or reduction of immunosuppressive therapy. The pneumatosis resolved over a period of several weeks without sequelae or recurrence.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
9/12. pneumatosis cystoides intestinalis. Presentation as an acute abdomen.It is rare for pneumatosis cystoides intestinalis to give rise to abdominal pain. We report a patient with signs and symptoms of a perforated viscous in whom abdominal exploration was negative, but in whom biopsy of various intraabdominal cystic structures revealed only pneumatosis cystoides intestinalis.- - - - - - - - - - ranking = 4keywords = abdomen (Clic here for more details about this article) |
10/12. pneumatosis cystoides intestinalis in systemic lupus erythematosus with intestinal vasculitis: treatment with high dose prednisone.pneumatosis cystoides intestinalis (PCI) is an uncommon disorder usually associated with intestinal and pulmonary obstructive diseases, recent abdominal procedures and systemic illnesses. PCI has been reported in patients with systemic lupus erythematosus associated with intestinal vasculitis. We describe herein a patient with a month history of intermittent abdominal pain, diarrhoea, hyporexia, and weight loss who underwent intestinal resection for acute abdomen. Post-operatively she gave a three-month history of arthritis of the right knee, ankles and feet, arthralgia of the wrists, MCPs and shoulders. She also described weakness, weight loss, Raynaud's phenomenon, and a skin rash. Laboratory examination revealed an increased ESR, low haemoglobin and haematocrit, positive rheumatoid factor, a positive ANA with a speckled pattern, as well antibodies to dna, SS-A and cardiolipin. The abdominal symptomatology especially pain, cramps and bouts of diarrhoea persisted after the surgery and became worse two months later. Abdominal X-ray showed distention of bowel with cyst formation in the wall of the entire colon. A diagnosis of PCI was made radiologically. The intestinal pathology was reviewed and vasculitis was identified. The patient received treatment with high dose prednisone with an excellent response; prednisone was progressively tapered and she has been asymptomatic without abdominal complaints or other symptoms for over a year.- - - - - - - - - - ranking = 1keywords = abdomen (Clic here for more details about this article) |
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