intestinal pneumatosis

PO

Definition: Pneumatosis intestinalis refers to presence of gas in the intestinal wall. In the majority of cases (85%), it is a result of a variety of clinical conditions. In the other 15%, it is primary or idiopathic in etiology.

The pathogenesis is multifactorial, including intraluminal gas, intestinal flora, mucosal integrity, and intraluminal pressure.

Cysts are either submucosal, seen often in the colon, or subserosal, seen in the small intestine.

Image

 pneumatosis cystoides intestinalis

• https://twitter.com/hhaltasmd/status/732592590864973825

Synopsis

 diarrhea
 hematochezia
 circumferential polypoid lesions
 superficial mucosal hemorrhages
 "crackling" noise
 multiple polypoid, air filled, submucosal cysts that ranged in size from 0.4-1.6 cm

Subtypes

 pneumatosis cystoides intestinalis

Associations (Examples)

 ischemic enteritis
 AIDS
 CMV infection
 transplantation (allograft)

• cardiac allograft
• pulmonary allograft

 cystic fibrosis (16702447, 8835977)

See also

 digestive pneumatosis

• intestinal pneumatosis
• colonic pneumatosis (pneumatosis coli)

References

 Koreishi A, Lauwers GY, Misdraji J. Pneumatosis intestinalis: a challenging biopsy diagnosis. Am J Surg Pathol. 2007 Oct;31(10):1469-75. PMID: 17895747

 Pear BL.Pneumatosis intestinalis: a review. Radiology. 1998 Apr;207(1):13-9. PMID: 9530294

 Koss LG. Abdominal gas cysts (pneumatosis cystodies intestinorum hominis) (an analysis with a report of a case and a critical review of the literature). Arch Pathol. 1953;53:523-549.

 Shoesmith J, Crone W. Pneumatosis cystoides intestinalis. Br J Surg. 1959;46:601-602.