Overview.
Intestinal pneumocystosis (PCI), also known as cystic intestinal pneumatosis, Duvernoy syndrome, intestinal emphysema, abdominal pneumocysts, and cystic lymphocystic pneumatosis, or if it occurs exclusively in the colon, cystic intestinal pneumatosis (CIP), is a very rare gastrointestinal disorder. Intestinal pneumocystosis is characterized by the presence of multiple inflatable cysts under the submucosa and/or plasma membrane of the intestinal wall, which may be surrounded by inflammation and fibrosis. It is often secondary to chronic lung disease, pyloric obstruction, intestinal obstruction, etc. A few have no primary pathology to be found, and the patient’s clinical manifestations are quite variable, sometimes due to abdominal distension and pain and emergency medical treatment.
Etiology
The cause of gas cyst is not clear, the intestinal gas in the lumen under increased pressure, from the ulcer or ulceration along the tissue gap into the intestinal wall, low-toxicity gas-producing bacilli from the intestinal mucosa into the lymphatic vessels, reproduction of gas to form a gas cyst. The appearance of the cyst resembles polyp or lymphangioma, the section is honeycomb, there is connective tissue around the cyst, and the cyst is not accessible to the intestinal lumen.
Symptoms
Clinical symptoms are mild, there may be lower abdominal pain, mucus soft stools, diarrhea and may have gas bubbles. It can lead to gastrointestinal bleeding, intestinal obstruction, intestinal torsion and pneumomediastinum.
Examination
1. X-ray direct signs include double marginal signs along the intestinal wall or gas bands along the long axis of the intestinal tube or confined round gas accumulation shadows arranged in a scattered manner.
2. After filling with barium, there may be cystic translucent areas of varying sizes at the edge of the intestinal wall or in the lumen. Indirect signs may include pneumoperitoneum, mediastinal emphysema, and interstitial small bowel or colon.
3. Fiberoptic enteroscopy may show a round, light blue polypoid soft tissue mass protruding into the lumen, and biopsy may show exhaustion and collapse of the cyst.
Diagnosis
According to the clinical manifestations, X-ray examination, fiberoptic enteroscopy and biopsy may have exhaust and see the collapse of the cyst are helpful for diagnosis.
Treatment
To treat the disease in question, hyperbaric oxygen therapy is available. Surgical resection is feasible for severe patients or those with serious complications.
Prognosis
The disease is prone to recurrence.
Prevention
Avoid increased abdominal pressure.