Zusammenfassung
Die Pneumatosis (cystoides) intestinalis kann überall im Gastrointestinaltrakt auftreten und ist durch Lufteinschlüsse in der Darmwand definiert. In Abhängigkeit von der Ursache kann die Prognose gut oder lebensbedrohlich sein: die häufigsten Auslöser sind infektiöse und medikamentös-toxische Kolitis, nekrotisierende Enterokolitis, Ischämie sowie vorausgegangene endoskopische Untersuchungen. Wir stellen zwei Fälle von asymptomatischer Pneumatosis coli vor, die in einem Fall primär an ein Polypose-Syndrom, im anderen an ein Malignom denken ließen. Beide Fälle wurden durch Schlingenpolypektomie oder Hemikolektomie histologisch verifiziert. Die Differenzialdiagnose und klinische Signifikanz der Pneumatosis (cystoides) intestinalis werden ausführlich diskutiert. Die Stellung der korrekten Diagnose, basierend auf Endoskopie, Computertomographie und Histologie, ist unabdingbar für die Therapie Betroffener und dient der Vermeidung unnötiger chirurgischer Eingriffe.
Summary
Pneumatosis (cystoides) intestinalis is defined as the presence of gas in the bowel wall and can be found anywhere in the gastrointestinal tract. It may be harmless or life-threatening, depending on the etiology which includes infectious and drug-induced colitis, bowel ischemia and necrotizing enterocolitis. The lesion has additionally been described following endoscopy. We report two cases of asymptomatic pneumatosis coli mimicking polyposis syndrome or malignancy. Both cases were verified histologically after snare polypectomy or hemicolectomy. The differential diagnosis and the clinical significance of the disease are discussed. Accurate diagnosis, which is mainly based upon endoscopy, computed tomography and histology, is crucial for optimal patient management thus avoiding unnecessary surgical procedures.
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Amrein, K., Högenauer, C., Spreizer, C. et al. Pneumatosis coli – an underrecognized lesion mimicking neoplastic disease. Wien Klin Wochenschr 123, 515–518 (2011). https://doi.org/10.1007/s00508-011-0007-y
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DOI: https://doi.org/10.1007/s00508-011-0007-y