“Cystamatic” Review: Is Surgery Mandatory for Pneumatosis Cystoides Intestinalis?

  • M. Brighi
  • S. Vaccari
  • A. LauroEmail author
  • V. D’Andrea
  • N. Pagano
  • I. R. Marino
  • M. Cervellera
  • V. Tonini



Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of intramural gas cysts within the small and large intestines. We describe a case of a 70-year-old man admitted to the Emergency Surgery Department for PCI who was treated conservatively.

Areas Covered

We reviewed 60 cases of PCI described in the international literature over the last 5 years. From our analysis, it appears that the etiology of the gas production within the submucosa or the subserosa of the gastrointestinal tract is still unknown. The rupture of the cysts can lead to pneumoperitoneum that can simulate a surgical emergency.

Expert Commentary

For patients with PCI, a conservative approach is the treatment of choice, with surgery mandatory only for complicated disease.


Pneumatosis cystoides intestinalis Conservative management Spontaneous pneumoperitoneum 



Computed tomography scan


Pneumatosis cystoides intestinalis


Chronic obstructive pulmonary disease


Compliance with Ethical Standards

Conflict of interest

None of the authors have any conflicts of interest pertaining to this work.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • M. Brighi
    • 1
  • S. Vaccari
    • 1
  • A. Lauro
    • 1
    Email author
  • V. D’Andrea
    • 2
  • N. Pagano
    • 1
  • I. R. Marino
    • 3
  • M. Cervellera
    • 1
  • V. Tonini
    • 1
  1. 1.Departments of Emergency Surgery and GastroenterologySt. Orsola University HospitalBolognaItaly
  2. 2.Department of Surgical SciencesLa Sapienza University, Umberto I HospitalRomeItaly
  3. 3.Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

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